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Tirasci E, Sarpel T, Coskun Benlidayi I, Deniz V. The effect of balance exercises on central sensitization in patients with knee osteoarthritis. Rheumatol Int 2024; 44:795-804. [PMID: 38492047 PMCID: PMC10980638 DOI: 10.1007/s00296-024-05550-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 01/25/2024] [Indexed: 03/18/2024]
Abstract
The aim of this study was to evaluate the effectiveness of balance exercises on functional status, pain, balance, and central sensitization in patients with knee osteoarthritis (OA). Patients diagnosed with bilateral Kellgren-Lawrence grade ≥ 2 primary knee OA and associated central sensitization were included in the study. Patients were randomized into two groups. Both groups were provided with verbal and written information on knee OA. In addition, the intervention group received a supervised balance exercise program for 6 weeks, 3 days a week on alternating days. The outcome measures were the changes in the Central Sensitization Inventory (CSI), Visual Analog Scale (VAS) pain, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Berg Balance Scale, and Y Balance Test. Evaluations were performed at baseline, immediately after treatment (6th week) and at 12th week. The study included 40 patients, 20 patients in each group. At the end of the treatment period (6th week), the improvement in CSI score, WOMAC pain, WOMAC physical function, WOMAC total score, Y Balance Test scores, and VAS pain during activity was significantly greater in the intervention group than that in the control group (p < 0.001). Regarding the changes from baseline to the 12th week, the intervention group experienced greater improvement in most of the outcome measures. Yet, the change in WOMAC pain score, Berg Balance Scale score, and VAS pain at rest was similar between the study groups (p = 0.05, p = 0.257, and p = 0.385, respectively). A two-model multiple linear regression analysis revealed that the changes in VAS pain (during activity) after the treatment and at follow-up [(p = 0.004, adjusted R2: 0.346) and (p = 0.002, adjusted R2: 0.391), respectively], as well as changes in WOMAC pain from baseline to follow-up (p = 0.020, ΔR2 = 0.245) significantly affected central sensitization. However, changes in Y Balance Test and WOMAC total scores did not appear to have a significant impact on the improvement in central sensitization (p > 0.05). Balance exercises may provide improvement in central sensitization, functional status, and dynamic balance among patients with knee OA. The improvement in central sensitization depends mostly on the pain relief effect of balance exercises.
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Affiliation(s)
- Emre Tirasci
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Cukurova University, Adana, Türkiye
| | - Tunay Sarpel
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Cukurova University, Adana, Türkiye
| | - Ilke Coskun Benlidayi
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Cukurova University, Adana, Türkiye.
| | - Volkan Deniz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Tarsus University, Mersin, Türkiye
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Lee J, Phu S, Lord SR, Okubo Y. Effects of immersive virtual reality training on balance, gait and mobility in older adults: A systematic review and meta-analysis. Gait Posture 2024; 110:129-137. [PMID: 38581933 DOI: 10.1016/j.gaitpost.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 02/21/2024] [Accepted: 03/13/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVE To examine whether immersive virtual reality (VR) can improve balance, gait, mobility and fear of falling in older people. DATA SOURCES MEDLINE, EMBASE, CINAHL, PsycINFO, ProQuest Central (Engineering and Computer Science) and reference lists of included articles. STUDY SELECTION Randomised controlled trials that administered immersive VR training and assessed balance, gait and mobility outcomes in older adults without neurological disorders (mean age ≥ 65). Primary outcomes were standing balance (e.g. postural sway), multi-item balance scales (e.g. Berg Balance Scale), gait (e.g. gait speed) and mobility (e.g. Timed Up and Go test). Secondary outcomes comprised measures of enjoyment, fear of falling, adherence (e.g. dropout rate), feasibility/usability and adverse effects (e.g. motion sickness). RESULTS Meta-analyses showed that immersive VR training significantly improved standing balance (SMD: 0.51, 95% CI: .15, 0.86, p = 0.005, I2 = 28% - 3 studies, n = 79) and performance on the Berg Balance Scale (MD: 2.36, 95% CI: 1.17, 3.56, p=0.0001, I2=0% - 4 studies, n = 190). No significant improvement in gait, mobility or fear of falling was found. Subgroup analyses revealed higher training doses (≥4.5 total hours) and VR interventions using non-head mounted displays were more likely to improve standing balance. No meta-analyses were conducted for enjoyment, adherence, feasibility/usability and adverse events. CONCLUSIONS The findings indicate immersive VR has beneficial effects on balance, but not gait, mobility or fear of falling. Further research is required to examine these outcomes in trials that also include quantitative measurements of enjoyment, adherence, clinical feasibility, usability and adverse effects.
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Affiliation(s)
- J Lee
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia; Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - S Phu
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia; Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - S R Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia; Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Y Okubo
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia; Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.
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Stania M, Emich-Widera E, Kamieniarz-Olczak A, Kazek B, Swatowska-Wenglarczyk M, Juras G. Postural control before and after transitional locomotor tasks in children on the autism spectrum: A case-control study. Clin Biomech (Bristol, Avon) 2024; 115:106251. [PMID: 38626570 DOI: 10.1016/j.clinbiomech.2024.106251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Instrumented measurements of postural control provide a more accurate insight into the motor development of children with autism. This study aimed to identify postural control deficits in autistic children during quiet standing before and after transient locomotor task. It was hypothesized that the parameters that characterize the trajectory of center of foot pressure (COP) displacement would be higher in autistic children compared to typically developing children. METHODS Sixteen autistic children aged 6-10 but without a comorbidity diagnosis, were enrolled in the study group. The control group comprised 16 typically developing peers. The assessment of the transitional task comprised four different conditions: unperturbed and perturbed transition, stepping up, and stepping down tasks. Analysis of the COP signal was carried out for three distinct phases, i.e., phase 1 - quiet standing before step initiation, phase 2 - transit, and phase 3 - quiet standing until measurement completion. FINDINGS The two-way ANOVA with a 2 × 4 factorial design (group × testing condition) revealed a group effect on all posturographic variables in the antero-posterior and medio-lateral directions of phase 1 and in the antero-posterior direction of phase 3. The Bonferroni post-hoc test showed the means of all those variables were significantly higher for the autistic than for typically developing children. Group allocation also had an effect on the time of transit and step length, which turned out to be significantly longer in autistic children compared to healthy peers. INTERPRETATION Autistic children show increased postural sway before and after transitional locomotor tasks compared to typically developing children. The trial was prospectively registered in the Australian and New Zealand Clinical Trials Registry (no. ACTRN12621001113842; date registered: 23.08.2021).
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Affiliation(s)
- Magdalena Stania
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland.
| | - Ewa Emich-Widera
- Department of Pediatric Neurology, Faculty of Medical Sciences, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland
| | - Anna Kamieniarz-Olczak
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland
| | - Beata Kazek
- Persevere - Child Development Support Center, Kępowa 56, 40-583 Katowice, Poland
| | | | - Grzegorz Juras
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland
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Obrero-Gaitán E, Sedeño-Vidal A, Peinado-Rubia AB, Cortés-Pérez I, Ibáñez-Vera AJ, Lomas-Vega R. Optokinetic stimulation for the treatment of vestibular and balance disorders: a systematic review with meta-analysis. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08604-1. [PMID: 38578505 DOI: 10.1007/s00405-024-08604-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/05/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES To analyse the effectiveness of optokinetic stimulation (OKS) for improving symptoms and function in patients with vestibular and balance disorders. METHODS PubMed (MEDLINE), SCOPUS, Web of Science (WOS), CINAHL Complete, and PEDro databases were searched to identify randomized controlled trials (RCTs) that included patients with vestibular and balance disorders and compared the effects of OKS versus other interventions or no intervention on subjective or objective functional outcomes. Data were analysed by the standardized mean difference (SMD) and its 95% confidence interval. RESULTS A total of 10 studies were selected including 468 patients, 177 of whom received OKS. There were no significant differences in scores on the Dizziness Handicap Inventory (DHI) (SMD = 0.02; 95% CI - 0.18 to 0.23; p = 0.83) or the visual analogue scale (VAS) for vertigo (SMD = 0.16; 95% CI - 1.25 to 1.58; p = 0.82). However, there were statistically significant differences in the timed up and go (TUG) test, with a large effect (SMD = - 1.13; 95% CI -2 to - 0.28; p = 0.009), and in the sensory organization test (SOT), with a medium effect (SMD = - 0.7; 95% CI - 1.21 to - 0.19; p = 0.007). Subgroup analysis showed significant effects of OKS on VAS (p = 0.017), TUG (p = 0.009) and SOT (p = 0.001) only in patients with balance disorders without vestibular disease (p > 0.05). CONCLUSIONS OKS may improve dizziness intensity measured with VAS or dynamic balance measured whit TUG and SOT in patients with balance disorders not due to vestibular disease. The quality of the evidence was low or very low due to the small number of included studies. PROSPERO REGISTRY NUMBER CRD42023445024.
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Miyata K, Kondo Y, Bando K, Hara T, Takahashi Y. Structural Validity of the Mini-Balance Evaluation Systems Test in Individuals With Spinocerebellar Ataxia: A Rasch Analysis Study. Arch Phys Med Rehabil 2024; 105:742-749. [PMID: 38218308 DOI: 10.1016/j.apmr.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/24/2023] [Accepted: 12/28/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVE To examine the structural validity of the Mini-Balance Evaluation Systems Test (Mini-BESTest) in individuals with spinocerebellar ataxia (SCA). DESIGN Methodological research on data gathered in a cross-sectional study. A Rasch analysis was conducted (partial credit model). SETTING Inpatients in a hospital rehabilitation setting. PARTICIPANTS A pooled sample of patients with SCA (N=65 [total 110 data]; 23 women, 42 men; mean±SD age 63.1±9.9y). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES We evaluated the Mini-BESTest's category structure, unidimensionality, and measurement accuracy (0: unable to perform or requiring help to 2: normal performance). RESULTS The Mini-BESTest rating scale fulfilled the category functioning criteria. The analysis of the standardized Rasch residuals showed the scale's unidimensionality, but there were 7 item pairs indicating local dependence. All of the items fit the underlying scale construct (dynamic balance), with the exception of item #1, "Sit to stand," which was an underfit. The Mini-BESTest demonstrated adequate reliability (person separation reliability=.87) and separated the patients into 5 strata. The item-difficulty measures ranged from -4.49 to 2.02 logits, and the person ability-item difficulty matching was very good (the mean of person ability=-.07 logits and the mean of item difficulty=.00). No floor or ceiling effects were detected. The keyform identified items with small (#11, "Walk with head turns, horizontal") and large (#3, "Stand on 1 leg") item thresholds. CONCLUSIONS The Mini-BESTest has a unidimensional balance assessment scale with good category structure and reliability even for individuals with SCA. However, it also has some inherent shortcomings such as fit statistics, local item dependencies, and item thresholds. The results obtained when the Mini-BESTest is administered to patients with cerebellar ataxia should, thus, be interpreted cautiously.
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Affiliation(s)
- Kazuhiro Miyata
- Department of Physical Therapy, Ibaraki Prefectural University of Health Science, Inashiki-gun.
| | - Yuki Kondo
- Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira
| | - Kyota Bando
- Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira
| | - Takatoshi Hara
- Department of Physical Rehabilitation, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira
| | - Yuji Takahashi
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
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Armat MR, Mortazavi H, Akbari H, Baghizade S. The Effect of Resistance Exercises Using an Elastic Band on Balance and Fear of Falling in Older Adults With Diabetic Peripheral Neuropathy: A 16-week Randomized Controlled Trial. Arch Phys Med Rehabil 2024; 105:733-741. [PMID: 38218307 DOI: 10.1016/j.apmr.2023.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/20/2023] [Accepted: 11/29/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVE The current study aimed to investigate the effect of resistance training using an elastic band on balance and fear of falling in older adults with diabetic peripheral neuropathy. DESIGN The study was a clinical controlled trial with a repeated measure design. SETTING Iranian Diabetes Foundation of Mashhad. PARTICIPANTS The participants were 51 older adults with diabetic peripheral neuropathy and balance impairment (N=51). INTERVENTIONS Participants were randomly assigned to 2 groups; 1 group received balance training using an elastic band and the other group just received balance training. MAIN OUTCOME MEASURES The main outcomes were balance and fear of falling that were measured using Berg Balance Scale and a short version of the Fall Efficiency Scale-International, respectively. RESULTS The results showed that balance resistance training with and without using an elastic band significantly enhances balance and reduces fear of falling in diabetic older adults suffering from balance issues. However, balance resistance training using an elastic band had a significantly better effect on the balance and fear of falling in the participants. The best results were obtained after week 12 (48 sessions of balance training). CONCLUSION Balance rehabilitation programs may include an elastic band in balance resistance training for 12 weeks (3-4 sessions a week) for enhancing balance in diabetic older adults suffering from balance impairment.
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Affiliation(s)
- Mohammad Reza Armat
- Geriatric Care Research Center, Department of Medical-Surgical Nursing, School of Nursing, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Hamed Mortazavi
- Geriatric Care Research Center, Department of Medical-Surgical Nursing, School of Nursing, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Hadi Akbari
- Addiction and Behavioral Sciences Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran.
| | - Saeedeh Baghizade
- School of Nursing, North Khorasan University of Medical Sciences, Bojnurd, Iran
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Abou L, McCloskey C, Wernimont C, Fritz NE, Kratz AL. Examination of Risk Factors Associated With Falls and Injurious Falls in People With Multiple Sclerosis: An Updated Nationwide Study. Arch Phys Med Rehabil 2024; 105:717-724. [PMID: 38043675 DOI: 10.1016/j.apmr.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 11/07/2023] [Accepted: 11/10/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE To provide an update on risk factors associated with falls and injurious falls among people with multiple sclerosis (PwMS) in the United States. DESIGN Nationwide cross-sectional web-based survey. SETTING Community setting. PARTICIPANTS Adult PwMS (n=965). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Participants completed self-report surveys of demographics, clinical data, concerns about falling, occurrence of falls, factors associated with falls, and injurious falls in the past 6 months. Participants also completed Patient-Reported Outcomes Measurement Information System (PROMIS) measures of depression, pain interference, and physical function, and the Fatigue Severity Scale. RESULTS The most common self-reported factors associated with falls included personal factors such as poor balance (75%), muscle weakness (54%), and/or fatigue (35%), environmental factors such as general surface conditions (37%) and/or distraction (15%), and activities-related factors such as urgency to complete a task (35%) and/or multitasking (27%). Logistic regression analyses indicated that higher fatigue severity (OR=1.19, P<.01) and higher pain interference (OR=1.02, P<.01) were associated with higher odds of experiencing at least 1 fall. Any level of concern, even minimal concern about falling was also significantly associated with a higher odd of experiencing at least 1 fall (ORs range 2.78 - 3.95, all P<.01). Fair to very high concerns about falling compared with no concern about falling (ORs range=5.17 - 10.26, all P<.05) was significantly associated with higher odds of sustaining an injurious fall. CONCLUSIONS Findings suggest falls prevention approaches in PwMS should be multifactorial and include personal, environmental, and activities-related factors. Particular attention on fatigue, pain, and concern about falling may be needed to reduce incidence of falls and injurious falls in this population.
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Affiliation(s)
- Libak Abou
- Department of Physical Medicine & Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI.
| | - Chloe McCloskey
- Department of Physical Medicine and Rehabilitation, Kaiser Permanente Health System, Redwood City, CA
| | - Cory Wernimont
- Department of Physical Medicine & Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI
| | - Nora E Fritz
- Departments of Health Care Sciences & Neurology, Wayne State University, Detroit, MI
| | - Anna L Kratz
- Department of Physical Medicine & Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI
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El-gohary TM, Al-Shenqiti AM, Alshehri YS, Aljohani MM. Ipsilateral versus contralateral static endurance- balance abilities among healthy college students. J Taibah Univ Med Sci 2024; 19:321-326. [PMID: 38299117 PMCID: PMC10828453 DOI: 10.1016/j.jtumed.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 12/25/2023] [Accepted: 12/27/2023] [Indexed: 02/02/2024] Open
Abstract
Objectives This study sought to determine the association and the difference, if any, between the levels of the contralateral and between the levels of the ipsilateral sides during static endurance-balance exercise. Methods One hundred twelve healthy active- college students (55 females and 57 males) participated in this cross-sectional study. Each participant performed the contralateral (raising one arm and opposite-side leg) quadruped bird dog exercise and balanced in static condition. Side bridge exercise was performed from lying on your side then engaging your core muscles and lifting your upper body and hips off the ground, maintaining a straight line and holding this position as long as tolerated. Results Wilcoxon signed rank test showed significant difference (p = 0.004) between the contralateral right and left quadruped bird dog but insignificant difference (p = 0.059) between the ipsilateral right and left side bridge endurance-balance exercises. Mann-Whitney U test showed that the holding time was significant across gender for the contralateral but was insignificant for the ipsilateral endurance-balance exercise. Mann-Whitney U test was insignificant (p > 0.05) between those being recreationally active or inactive. Kruskal-Wallis test revealed insignificant difference between body mass index categories. Spearman's rho correlation coefficient showed strong positive correlation equals 0.85 and 0.75 (p < 0.001) of the contralateral quadruped bird dog and the ipsilateral side bridge exercises respectively. Conclusions A significant difference was observed for contralateral, while no significant difference was found for ipsilateral endurance-balance abilities. Therefore, clinicians and rehab specialist should consider these findings when assessing the endurance-balance abilities to properly devise appropriate exercise progression of different trunk stabilizers.
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Affiliation(s)
- Tarek M. El-gohary
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Egypt
- Department of Physical Therapy, College of Medical Rehabilitation Sciences, Taibah University, KSA
| | - Abdullah M. Al-Shenqiti
- Department of Physical Therapy, College of Medical Rehabilitation Sciences, Taibah University, KSA
| | - Yasir S. Alshehri
- Department of Physical Therapy, College of Medical Rehabilitation Sciences, Taibah University, KSA
| | - Marwan M. Aljohani
- Department of Physical Therapy, College of Medical Rehabilitation Sciences, Taibah University, KSA
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Velghe S, Rameckers E, Meyns P, Johnson C, Hallemans A, Verbecque E, Klingels K. Effects of a highly intensive balance therapy camp in children with developmental coordination disorder - An intervention protocol. Res Dev Disabil 2024; 147:104694. [PMID: 38382234 DOI: 10.1016/j.ridd.2024.104694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 02/02/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND Children with Developmental Coordination Disorder (DCD) often (<87 %) experience postural control problems, impacting all levels of the International Classification of Functioning, Disability and Health (ICF) including their daily participation, self-esteem and mental health. Due to the multisystemic nature of postural control, comprehensive therapy should target all systems which is currently not the case. Highly intensive therapy is effective and commonly used in pediatric populations, but has not been explored yet to train postural control in children with DCD. AIMS To investigate the effects of a highly intensive functional balance therapy camp at all ICF levels in children with DCD. METHODS AND PROCEDURES The effects on postural control, muscle activity, brain alterations, self-perceived competence, self-identified goals, gross motor activities and participation are evaluated. Participants are assessed pre- and post-intervention, including a 3 months follow-up. Forty-eight children with DCD, aged 6-12 years old, receive 40 h of comprehensive balance training. This intervention is fun, individually tailored, targets all postural control systems, implements different motor learning strategies and includes both individual and group activities. CONCLUSION Novel insights into the effects of a highly intensive comprehensive balance therapy camp designed for children with DCD will be gained at all levels of the ICF.
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Affiliation(s)
- Silke Velghe
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.
| | - Eugene Rameckers
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; Department of Rehabilitation Medicine, Functioning, Participation & Rehabilitation research line, Research School CAPHRI, Maastricht University, Maastricht, the Netherlands; Centre of Expertise, Adelante Rehabilitation Centre, Valkenburg, the Netherlands
| | - Pieter Meyns
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Charlotte Johnson
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; Research group MOVANT, University of Antwerp, Antwerp, Belgium
| | - Ann Hallemans
- Research group MOVANT, University of Antwerp, Antwerp, Belgium
| | - Evi Verbecque
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Katrijn Klingels
- Rehabilitation Research Centre - REVAL, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
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Mao M, Mercer VS, Li F, Gross MT, Blackburn T, Yu B. The effect of Tai Chi lower extremity exercise on the balance control of older adults in assistant living communities. BMC Complement Med Ther 2024; 24:112. [PMID: 38448853 PMCID: PMC10918873 DOI: 10.1186/s12906-024-04382-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 01/29/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Although Tai Chi (TC) is an evidence-based fall prevention training for older adults, its effective movements remain unclear, which may limit the practice of TC. The purpose of this study was to compare the effectiveness of TC lower extremity exercise (TC LEE), the 8-form Tai Chi (8-form TC), and a stretching control intervention for improving balance and functional mobility among older adults. METHODS This was a randomized controlled trial. A total of 102 participants (79 ± 6 years old) were recruited from assisted living facilities. All participants were randomly assigned to the TC LEE (n = 40), 8-form TC (n = 31), and stretching (n = 31) groups in which they received the respective interventions for 16 weeks. The Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and center of pressure (COP) measurements during quiet stance were collected prior to and following the 16-week interventions. Comparisons on all measurements were conducted among all groups. RESULTS Significant improvements were found in BBS (P = 0.002), TUG test (P = 0.001), root mean square amplitude of COP displacement in the anterior-posterior (P = 0.001) and medial-lateral (P = 0.001) directions, and average COP speed in the anterior-posterior (P = 0.001) and medial-lateral (P = 0.001) directions after training in the TC intervention groups compared with the stretching group. The upper limit of the 95% confidence interval (CI) of differences in change scores on the BBS (-0.8 - 1.3 points) between the TC LEE group and the 8-form TC group was within equivalence margins (1.8 points), while the upper limit of the 95% CI of differences in change scores on the TUG test (0.1 - 2.1 s) exceeded the equivalence margin (0.7 s) with the TC LEE group having the larger change scores. CONCLUSION TC LEE can improve balance and functional mobility in older adults, and may have greater effect than the 8-form TC on improving functional mobility as measured by the TUG test. TRIAL REGISTRATION ChiCTR2300070600 retrospectively registered.
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Affiliation(s)
- Min Mao
- Division of Physical Therapy, The University of North Carolina at Chapel Hill, CB #7135 Bondurant Hall, Chapel Hill, NC, 27599-7135, USA
- Shandong University, School of Hursing and Rehabilitation, Jinan, Shandong, 250012, China
| | - Vicki S Mercer
- Division of Physical Therapy, The University of North Carolina at Chapel Hill, CB #7135 Bondurant Hall, Chapel Hill, NC, 27599-7135, USA
| | - Fuzhong Li
- Oregon Research Institute, 1715 Franklin Blvd., Eugene, OR, 97403, USA
| | - Michael T Gross
- Division of Physical Therapy, The University of North Carolina at Chapel Hill, CB #7135 Bondurant Hall, Chapel Hill, NC, 27599-7135, USA
| | - Troy Blackburn
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-8700, USA
| | - Bing Yu
- Division of Physical Therapy, The University of North Carolina at Chapel Hill, CB #7135 Bondurant Hall, Chapel Hill, NC, 27599-7135, USA.
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Conway Kleven B, Chien LC, Young DL, Cross CL, Labus B, Bernick C. Repetitive head impacts among professional fighters: a pilot study evaluating Traumatic Encephalopathy Syndrome and postural balance. PHYSICIAN SPORTSMED 2024:1-7. [PMID: 38418380 DOI: 10.1080/00913847.2024.2325331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 02/27/2024] [Indexed: 03/01/2024]
Abstract
OBJECTIVES Clinical criteria for Traumatic Encephalopathy Syndrome (ccTES) were developed for research purposes to reflect the clinical symptoms of Chronic Traumatic Encephalopathy (CTE). The aims of this study were to 1) determine whether there was an association between the research diagnosis of TES and impaired postural balance among retired professional fighters, and 2) determine repetitive head impacts (RHI) exposure thresholds among both TES positive and TES negative groups in retired professional fighters when evaluating for balance impairment. METHODS This was a pilot study evaluating postural balance among participants of the Professional Athletes Brain Health Study (PABHS). Among the cohort, 57 retired professional fighters met the criteria for inclusion in this study. A generalized linear model with generalized estimating equations was used to compare various balance measures longitudinally between fighters with and without TES. RESULTS A significant association was observed between a TES diagnosis and worsening performance on double-leg balance assessments when stratifying by RHI exposure thresholds. Additionally, elevated exposure to RHI was significantly associated with increased odds of developing TES; The odds for TES diagnosis were 563% (95% CI = 113, 1963; p-value = 0.0011) greater among athletes with 32 or more professional fights compared to athletes with less than 32 fights when stratifying by balance measures. Likewise, the odds for TES diagnosis were 43% (95% CI = 10, 102; p-value = 0.0439) greater with worsening double leg stance balance in athletes exposed to 32 or more fights. CONCLUSION This pilot study provides preliminary evidence of a relationship between declining postural balance and a TES diagnosis among retired professional fighters with elevated RHI exposure. Further research exploring more complex assessments such as the Functional Gait Assessment may be of benefit to improve clinical understanding of the relationship between TES, RHI, and balance.
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Affiliation(s)
- Brooke Conway Kleven
- Sports Innovation Institute, University of Nevada, Las Vegas, Las Vegas, NV, USA
- School of Public Health, Department of Epidemiology and Biostatistics, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Lung-Chang Chien
- School of Public Health, Department of Epidemiology and Biostatistics, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Daniel L Young
- School of Integrated Health Sciences, Department of Physical Therapy, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Chad L Cross
- School of Public Health, Department of Epidemiology and Biostatistics, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Brian Labus
- School of Public Health, Department of Epidemiology and Biostatistics, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Charles Bernick
- Department of Neurology, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
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12
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Kachouri H, Jouira G, Laatar R, Borji R, Rebai H, Sahli S. Different types of combined training programs to improve postural balance in single and dual tasks in children with intellectual disability. J Intellect Disabil 2024; 28:225-239. [PMID: 36571852 DOI: 10.1177/17446295221148585] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
The study explored the effects of two combined training (Strength-Proprioceptive versus Cognitive-Balance) programs on postural balance during single-task and dual-task conditions in children with intellectual disability. The postural balance and the second cognitive-task performances were evaluated before and after 8-week of training in two groups: Strength-Proprioceptive Group (n = 12) and Cognitive-Balance Group (n = 10). Results showed that, in both groups and regardless of the training effect, the postural balance performance was significantly (p < 0.05) altered in the dual-task condition compared to the single-task one. After-training session, postural balance performance was improved significantly (p < 0.001) for all task conditions. After training session, the second cognitive-task performance was improved in the Strength-Proprioceptive Group (p < 0.001) and Cognitive-Balance Groupe (p < 0.05). In conclusion, the combined training programs, Strength-Proprioceptive and Cognitive-Balance, improved postural balance performance in single-task and dual-task conditions in children with intellectual disability.
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Affiliation(s)
- Hiba Kachouri
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Ghada Jouira
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Rabeb Laatar
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Rihab Borji
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Haithem Rebai
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
| | - Sonia Sahli
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Tunisia
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Skiba MB, El-Gohary M, Horak F, Dieckmann NF, Guidarelli C, Meyers G, Hayes-Lattin B, Winters-Stone K. Assessment of Mobility Trajectories Using Wearable Inertial Sensors During Autologous Hematopoietic Cell Transplant. Arch Phys Med Rehabil 2024:S0003-9993(24)00092-3. [PMID: 38354878 DOI: 10.1016/j.apmr.2024.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE This study aimed to characterize mobility patterns using wearable inertial sensors and serial assessment across autologous hematopoietic cell transplant (autoHCT) and investigate the relation between mobility and perceived function in patients with hematologic cancer. DESIGN Prospective longitudinal study. SETTING Hospital adult transplant clinic followed by discharge. PARTICIPANTS 78 patients with hematological cancer receiving autoHCT. MAIN OUTCOME MEASURES Mobility was measured across 3 clinical phases (pretransplant, pre-engraftment, and post-engraftment) in using inertial sensors worn during prescribed performance tests in the hospital. Perceived function was assessed using validated provider-reported (Eastern Cooperative Oncology Group [ECOG] Performance Status Scale) and patient-reported [European Organization for Research and Treatment of Cancer Quality of Life Questionnaire [EORTC QLQ-C30]) measures. Trajectories of 5 selected mobility characteristics (turn duration, gait speed, stride time variability, double support time, and heel strike angle) across the clinical phases were also evaluated using piecewise linear mixed-effects models. RESULTS Using Principal Components Analysis, 4 mobility patterns were identified pretransplant: Gait Limitation, Sagittal Sway, Coronal Sway, and Balance Control. Gait Limitation measured pretransplant was significantly inversely associated with perceived function reported by the provider- (β = -0.11; 95% CI: -0.19, -0.02) and patient- (β = -4.85; 95% CI: -7.72, -1.99) post-engraftment in age-adjusted linear regression models. Mobility characteristics demonstrated immediate declines early pre-engraftment with stabilization by late pre-engraftment. CONCLUSION Patients with hematological cancer experiencing gait limitations pretransplant are likely to have worse perceived function post-engraftment. Mobility declines in early phases post-transplant and may not fully recover, indicating an opportunity for timely rehabilitation referrals. Wearable inertial sensors can be used to identify early mobility problems and patients who may be at risk for future functional decline who may be candidates for early physical rehabilitation.
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Affiliation(s)
- Meghan B Skiba
- Advanced Nursing Practice and Science Division, College of Nursing, University of Arizona, Tucson, AZ; University of Arizona Cancer Center, Tucson, AZ; Division of Oncological Sciences, Knight Cancer Institute, School of Medicine, Oregon Health & Science University, Portland OR
| | | | - Fay Horak
- APDM, a Clario Inc Company, Portland, OR; Department of Neurology, School of Medicine, Oregon Health & Science University, Portland OR
| | | | - Carolyn Guidarelli
- Division of Oncological Sciences, Knight Cancer Institute, School of Medicine, Oregon Health & Science University, Portland OR
| | - Gabrielle Meyers
- Division of Hematology and Medical Oncology, School of Medicine, Oregon Health & Science University, Portland, OR
| | - Brandon Hayes-Lattin
- Division of Hematology and Medical Oncology, School of Medicine, Oregon Health & Science University, Portland, OR
| | - Kerri Winters-Stone
- Division of Oncological Sciences, Knight Cancer Institute, School of Medicine, Oregon Health & Science University, Portland OR.
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Arin-Bal G, Livanelioglu A, Leardini A, Belvedere C. Correlations between plantar pressure and postural balance in healthy subjects and their comparison according to gender and limb dominance: A cross-sectional descriptive study. Gait Posture 2024; 108:124-131. [PMID: 38039867 DOI: 10.1016/j.gaitpost.2023.11.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/07/2023] [Accepted: 11/22/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND Lower extremity injuries rank among the most common injuries affecting young population, and numerous factors affect the outcomes of plantar pressure and balance assessment. RESEARCH QUESTION Does a correlation exist between plantar pressure and postural balance in healthy subjects and are there any difference in the results based on gender and limb dominance? METHODS This study involved thirty healthy recreationally active young adults (15 females, 15 males). Plantar pressures were analyzed using the MatScan Pressure Mat System, and postural balance was evaluated using Biodex Balance System. All assessments conducted under both static and dynamic conditions. Correlations were tested by Spearman Correlation Coefficient, and comparative tests were performed for gender and limb dominance. RESULTS Correlations were observed between plantar pressure parameters and balance scores, particularly in the dynamic conditions (p < 0.05). Gender-based differences were noted in plantar pressure parameters (p < 0.05), with females demonstrating improved balance stability scores. No significant differences were found based on limb dominance in plantar pressure and postural balance data (p > 0.05). SIGNIFICANCE This study provides valuable detailed insights into the existing literature concerning plantar pressure and postural balance assessments within the healthy population. A strong correlation was observed between plantar pressure and postural balance, and the comparisons of these assessments were affected by gender but not by limb dominance. These results could lead the way for better rehabilitation approaches by considering the correlations and differences across diverse populations.
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Affiliation(s)
- Gamze Arin-Bal
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey.
| | - Ayse Livanelioglu
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Alberto Leardini
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Claudio Belvedere
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Wijnands SDN, Grin L, van Dijk LS, Besselaar AT, van der Steen MC, Vanwanseele B. Clubfoot patients show more anterior-posterior displacement during one-leg-standing and less ankle power and plantarflexor moment during one-leg-hopping than typically developing children. Gait Posture 2024; 108:361-366. [PMID: 38227996 DOI: 10.1016/j.gaitpost.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 01/18/2024]
Abstract
BACKGROUND Clubfoot patients show good-to-excellent foot correction after the Ponseti method. Nevertheless, underlying functional problems that limit motor abilities such as one-leg-standing and one-leg-hopping still persist. These restrictions have been proposed to arise due to problems with maintaining balance and the limited force-generating capacity of clubfoot patients. More insight is needed to understand the underlying limiting factors to improve overall motor ability in clubfoot patients. RESEARCH QUESTION The aim of this study was to determine the differences between clubfoot patients and typically developing children (TDC) in force and balance parameters during walking, one-leg-standing and hopping. METHODS Three-dimensional motion analysis was performed in 19 TDC and 16 idiopathic Ponseti-treated clubfoot patients between 5-9 years old. Kinematic and kinetic parameters were calculated during walking and one-leg-hopping. To describe the balance parameters, center of pressure (CoP) data was assessed during walking, one-leg-hopping and one-leg-standing. Mean group values were calculated and compared using nonparametric statistical tests. A general linear model with repeated measures was used to determine which activity showed the largest group differences. RESULTS Clubfoot patients showed lower peak plantarflexor moment and peak ankle power absorption and generation during one-leg-hopping compared to TDC. Furthermore, clubfoot patients showed a lower hop length and velocity than TDC. The difference in peak plantarflexor moment and ankle power between the study groups was larger during one-leg-hopping than during walking. Finally, clubfoot patients showed a higher anterior-posterior CoP range during one-leg-standing. SIGNIFICANCE Deviations in force parameters seemed to limit one-leg-hopping in clubfoot patients, and impaired anterior-posterior static balance was thought to be the underlying cause of problems with one-leg-standing. Furthermore, one-leg-hopping was more sensitive to distinguish between clubfoot patients and TDC than walking. Individualized physiotherapy targeting static balance and force parameters, with extra emphasis on including eccentric contractions, might improve the overall motor abilities of clubfoot patients.
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Affiliation(s)
- S D N Wijnands
- Human Movement Biomechanics Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Postbus 550, 3000 Leuven, Belgium; Department of Orthopaedic Surgery & Trauma, Máxima MC, Postbus 90052, 5600 PD Eindhoven, the Netherlands
| | - L Grin
- Human Movement Biomechanics Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Postbus 550, 3000 Leuven, Belgium; Fontys University of Applied Sciences, Postbus 347, 5612 MA Eindhoven, the Netherlands.
| | - L S van Dijk
- Fontys University of Applied Sciences, Postbus 347, 5612 MA Eindhoven, the Netherlands
| | - A T Besselaar
- Department of Orthopaedic Surgery & Trauma, Máxima MC, Postbus 90052, 5600 PD Eindhoven, the Netherlands; Department of Orthopaedic Surgery & Trauma, Catharina Hospital Eindhoven, Postbus 1350, 5602 ZA Eindhoven, the Netherlands
| | - M C van der Steen
- Department of Orthopaedic Surgery & Trauma, Máxima MC, Postbus 90052, 5600 PD Eindhoven, the Netherlands; Department of Orthopaedic Surgery & Trauma, Catharina Hospital Eindhoven, Postbus 1350, 5602 ZA Eindhoven, the Netherlands
| | - B Vanwanseele
- Human Movement Biomechanics Research Group, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Postbus 550, 3000 Leuven, Belgium; Fontys University of Applied Sciences, Postbus 347, 5612 MA Eindhoven, the Netherlands
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16
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Zhang T, Huo Y, Yin W, Xiang J. Postural balance disorders in sarcopenia based on surface electromyography. Heliyon 2024; 10:e24116. [PMID: 38283248 PMCID: PMC10818193 DOI: 10.1016/j.heliyon.2024.e24116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 12/12/2023] [Accepted: 01/03/2024] [Indexed: 01/30/2024] Open
Abstract
Background Sarcopenia is an intrinsic factor that leads to balance disorders and falls in older adults. However, the characterization of sarcopenia-related postural balance deficits remains unclear. Aims This study aimed to explore the balance performance and postural control strategy in older adults with sarcopenia during static stance tasks using force platforms and surface electromyography. Methods Older adults with right-sided dominance were recruited, including 27 adults with sarcopenia and 27 healthy counterparts. Postural sway was measured with eyes open/closed on rigid/compliant surfaces. The time- and frequency-domain indexes of bilateral lower extremity muscle activity were simultaneously recorded. Results The postural sway and activity of multiple lower extremity muscles in the sarcopenia group were increased (P < 0.05). The amplitude contribution ratio of the right tibialis anterior muscle (larger in sarcopenia), co-contraction ratio of right ankle dorsiflexion (smaller in sarcopenia), and mean power frequency and median frequency of the left gluteus maximus muscle (smaller in sarcopenia) had main effects of grouping (P < 0.001, η2p = 0.06-0.10). All of them had discrimination for sarcopenia (area under the curve = 0.639-0.657, P < 0.001) and were correlated with balance function measurement in sarcopenia (|rs| = 0.22-0.44, P < 0.05). Conclusion The results of this study suggest that older adults with sarcopenia have decreased balance function and increased cost of electrophysiology. They were found to prefer the postural strategy of dominant ankle dorsiflexion and demonstrated overactivity of the dominant tibialis anterior muscles and fatigue vulnerability of the nondominant gluteus maximus. Improvements in these postural features may have balance benefits.
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Affiliation(s)
- Ting Zhang
- Medical Technology School, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Department of Rehabilitation, Wuxi Ninth People's Hospital Affiliated to Soochow University, Wuxi, Jiangsu, 214000, China
| | - Yang Huo
- The Second School of Clinical Medicine, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Wenjing Yin
- The Second School of Clinical Medicine, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Jie Xiang
- Medical Technology School, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- The Second School of Clinical Medicine, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Department of Rehabilitation, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, 221002, China
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17
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Kim BJ, Ha K, Kim HS, Bae HR, Son M. Associations of depressive symptoms with lower extremity function and balance in Korean older adults. Epidemiol Health 2024; 46:e2024021. [PMID: 38271960 DOI: 10.4178/epih.e2024021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
OBJECTIVES The relationship of depressive symptoms to lower extremity function and balance, especially in older adults without a depression diagnosis, remains unclear. Therefore, our study analyzed this relationship using a large sample of Korean older adults. METHODS We used data from the Korean National Health Insurance Service's Health Screening Program database. Individuals aged 66 years who had undergone the National Screening Program for Transitional Ages in Korea and were without a diagnosis of depressive disorder were included. The lower extremity function and balance were evaluated using 2 physical tests, while depressive symptoms were assessed using a 3-question survey. Multivariable-adjusted logistic regression analysis was used to examine the association between depressive symptoms and lower extremity function and balance. RESULTS Among 66,041 individuals, those with depressive symptoms showed significantly higher rates of abnormal lower extremity function and abnormal balance. The adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association of depressive symptoms to abnormal lower extremity function and abnormal balance were (aOR, 1.34; 95% CI, 1.25 to 1.44) and (aOR, 1.38; 95% CI, 1.29 to 1.48), respectively. Assessment of the relationship based on depressive symptom scores revealed that higher scores were associated with higher aORs (p for trend <0.001). Subgroup analyses further confirmed this relationship, especially among patients with cerebrovascular disease or dementia. CONCLUSIONS This study revealed an association between depressive symptoms and the abnormal lower extremity function and balance of 66-year-old individuals without a diagnosis of depressive disorder.
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Affiliation(s)
- Bong Jo Kim
- Department of Physiology, Dong-A University College of Medicine, Busan, Korea
| | - Kyupin Ha
- Department of Physiology, Dong-A University College of Medicine, Busan, Korea
| | - Hyun Soo Kim
- Department of Psychiatry, Dong-A University College of Medicine, Busan, Korea
| | - Hye Ran Bae
- Department of Physiology, Dong-A University College of Medicine, Busan, Korea
| | - Minkook Son
- Department of Physiology, Dong-A University College of Medicine, Busan, Korea
- Department of Data Sciences Convergence, Dong-A University Interdisciplinary Program, Busan, Korea
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18
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Sánchez Martínez MP, Sánchez-Barbadora M, Moreno-Segura N, Beltrá P, Escriche-Escuder A, Martín-San Agustín R. Responsiveness of monopodal postural stability tests in recreational athletes. PeerJ 2024; 12:e16765. [PMID: 38223752 PMCID: PMC10788087 DOI: 10.7717/peerj.16765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/14/2023] [Indexed: 01/16/2024] Open
Abstract
Background Stabilometry, the modified Star Excursion Balance Test (mSEBT) or the Emery balance test (EBT) are reported in the literature to reflect changes after an intervention in monopodal postural stability. Even so, the responsiveness of those tests has not been evaluated after an instability training programme or analysed using multiple statistical indicators of responsiveness. The main aim of this study was to analyse the responsiveness of the stabilometry, mSEBT or EBT. Methods Thirty healthy recreational athletes performed a 4-week programme with three weekly sessions of instability training of the dominant lower limb and were evaluated using stabilometry, mSEBT, and EBT tests. Responsiveness was quantified based on internal and external responsiveness. Results EBT and all parameters in mSEBT for the dominant lower limb showed large internal responsiveness (SRM > 0.8). Furthermore, mSEBT values for the non-dominant lower limb (except anterior displacement) also experienced significant changes with an associated large internal responsiveness. None of the stabilometry platform parameters showed a significant change after the intervention. The ability of the EBT to discriminate between the dominant and non-dominant lower limb (i.e., trained vs untrained, respectively) was generally acceptable (AUCs = 0.708). However, none of the parameters of the mSEBT test showed an acceptable AUC. Conclusions EBT showed a positive responsiveness after instability training compared to mSEBT, which only showed internal responsiveness, or stabilometry platform measures, whose none of the parameters could identify these changes.
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Affiliation(s)
| | | | | | - Patricia Beltrá
- Faculty of Health Sciences, Universidad Europea de Valencia, Valencia, Spain
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Bakker LBM, Lamoth CJC, Vetrovsky T, Gruber M, Caljouw SR, Nieboer W, Taube W, van Dieën JH, Granacher U, Hortobágyi T. Neural Correlates of Balance Skill Learning in Young and Older Individuals: A Systematic Review and Meta-analysis. Sports Med Open 2024; 10:3. [PMID: 38185708 PMCID: PMC10772137 DOI: 10.1186/s40798-023-00668-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 12/16/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Despite the increasing number of research studies examining the effects of age on the control of posture, the number of annual fall-related injuries and deaths continues to increase. A better understanding of how old age affects the neural mechanisms of postural control and how countermeasures such as balance training could improve the neural control of posture to reduce falls in older individuals is therefore necessary. The aim of this review is to determine the effects of age on the neural correlates of balance skill learning measured during static (standing) and dynamic (walking) balance tasks in healthy individuals. METHODS We determined the effects of acute (1-3 sessions) and chronic (> 3 sessions) balance skill training on balance in the trained and in untrained, transfer balance tasks through a systematic review and quantified these effects by robust variance estimation meta-analysis in combination with meta-regression. We systematically searched PubMed, Web of Science, and Cochrane databases. Balance performance and neural plasticity outcomes were extracted and included in the systematic synthesis and meta-analysis. RESULTS Forty-two studies (n = 622 young, n = 699 older individuals) were included in the systematic synthesis. Seventeen studies with 508 in-analysis participants were eligible for a meta-analysis. The overall analysis revealed that acute and chronic balance training had a large effect on the neural correlates of balance skill learning in the two age groups combined (g = 0.79, p < 0.01). Both age groups similarly improved balance skill performance in 1-3 training sessions and showed little further improvements with additional sessions. Improvements in balance performance mainly occurred in the trained and less so in the non-trained (i.e., transfer) balance tasks. The systematic synthesis and meta-analysis suggested little correspondence between improved balance skills and changes in spinal, cortical, and corticospinal excitability measures in the two age groups and between the time courses of changes in balance skills and neural correlates. CONCLUSIONS Balance skill learning and the accompanying neural adaptations occur rapidly and independently of age with little to no training dose-dependence or correspondence between behavioral and neural adaptations. Of the five types of neural correlates examined, changes in only spinal excitability seemed to differ between age groups. However, age or training dose in terms of duration did not moderate the effects of balance training on the changes in any of the neural correlates. The behavioral and neural mechanisms of strong task-specificity and the time course of skill retention remain unclear and require further studies in young and older individuals. REGISTRATION PROSPERO registration number: CRD42022349573.
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Affiliation(s)
- Lisanne B M Bakker
- Department of Human Movement Sciences, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9700 AD, Groningen, The Netherlands.
| | - Claudine J C Lamoth
- Department of Human Movement Sciences, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9700 AD, Groningen, The Netherlands
| | - Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Markus Gruber
- Department of Sport Science, Human Performance Research Centre, University of Konstanz, Constance, Germany
| | - Simone R Caljouw
- Department of Human Movement Sciences, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9700 AD, Groningen, The Netherlands
| | - Ward Nieboer
- Department of Human Movement Sciences, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9700 AD, Groningen, The Netherlands
| | - Wolfgang Taube
- Department of Neurosciences and Movement Sciences, University of Fribourg, Fribourg, Switzerland
| | - Jaap H van Dieën
- Department of Human Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Urs Granacher
- Department of Sport and Sport Science, Exercise and Human Movement Science, University of Freiburg, Freiburg, Germany
| | - Tibor Hortobágyi
- Department of Human Movement Sciences, Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, A. Deusinglaan 1, 9700 AD, Groningen, The Netherlands
- Department of Kinesiology, Hungarian University of Sports Science, Budapest, Hungary
- Institute of Sport Sciences and Physical Education, University of Pécs, Pecs, Hungary
- Somogy County Kaposi Mór Teaching Hospital, Kaposvár, Hungary
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García-Arandilla A, Gonzàlez-Gàzquez T, Morgado-Pérez A, Davalos Yerovi V, Tejero-Sánchez M, Meza-Valderrama D. [Hippotherapy versus hippotherapy simulators as a treatment option in children with cerebral palsy: A systematic review]. Rehabilitacion (Madr) 2024; 58:100816. [PMID: 37862777 DOI: 10.1016/j.rh.2023.100816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 10/22/2023]
Abstract
INTRODUCTION AND OBJECTIVE Hippotherapy (HPOT) and hippotherapy simulators (SHPOT) are used in children with cerebral palsy to achieve their maximum functionality and independence. The aim is to find out if HPOT and SHPOT produce the same effects on balance, gross motor function, and postural control in children under 18 years old with cerebral palsy. MATERIALS AND METHODS The keywords used were: hippotherapy, equine-assisted therapy and cerebral palsy. The databases used were PeDro, Scopus, LILACS, ScienceDirect, Cochrane Library, Web of Science and CINAHL Complete (Ebsco). Studies were included if they were randomized clinical trials that studied the effect of HPOT and/or SHPOT on the variables mentioned in these patients. RESULTS Four studies assessed balance, 4 studied gross motor function, and 2 investigated postural control. Both HPOT and SHPOT produced benefits in all of them. CONCLUSIONS According to the studied variables both interventions produce similar improvements. Although, they increase with HPOT possibly due to greater sensory stimulation.
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Affiliation(s)
- A García-Arandilla
- Facultad de Medicina, Universitat Autònoma de Barcelona, Barcelona, España; Grupo de Investigación en Rehabilitación (RERG), Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, España.
| | - T Gonzàlez-Gàzquez
- Facultad de Medicina, Universitat Autònoma de Barcelona, Barcelona, España; Grupo de Investigación en Rehabilitación (RERG), Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, España
| | - A Morgado-Pérez
- Grupo de Investigación en Rehabilitación (RERG), Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, España; Servicio de Medicina Física y Rehabilitación, Parc de Salut Mar (Hospital del Mar-Hospital de l'Esperança), Barcelona, España
| | - V Davalos Yerovi
- Grupo de Investigación en Rehabilitación (RERG), Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, España; Servicio de Medicina Física y Rehabilitación, Parc de Salut Mar (Hospital del Mar-Hospital de l'Esperança), Barcelona, España
| | - M Tejero-Sánchez
- Grupo de Investigación en Rehabilitación (RERG), Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, España; Servicio de Medicina Física y Rehabilitación, Parc de Salut Mar (Hospital del Mar-Hospital de l'Esperança), Barcelona, España
| | - D Meza-Valderrama
- Grupo de Investigación en Rehabilitación (RERG), Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, España; Servicio de Medicina Física y Rehabilitación, Instituto Nacional de Medicina Física y Rehabilitación (INFRE), Panamá, Panamá
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Xue X, Yu L, Zheng S, Gu X, Na Y, Xia T, Jue H, Chen T, Li H, Li H, Wang R, Hua Y. Insufficient recovery of proprioception in chronic ankle instability after surgical restabilization: A systematic review. Asia Pac J Sports Med Arthrosc Rehabil Technol 2024; 35:48-58. [PMID: 38204486 PMCID: PMC10776890 DOI: 10.1016/j.asmart.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/16/2023] [Accepted: 11/27/2023] [Indexed: 01/12/2024] Open
Abstract
Surgical repair or reconstruction of the lateral ligaments for patients with chronic ankle instability (CAI) could, logically, restore the proprioception of ankle through retensing receptors. To validate this hypothesis, seven databases were systematically searched, and thirteen studies comprising a total of 347 patients with CAI were included. Although five studies reported improved proprioceptive outcomes after surgeries, the other five studies with between-limb/group comparisons reported residual deficits at final follow-up, which does not consistently support proprioceptive recovery after existing surgical restabilization for CAI. More controlled studies are needed to provide evidence-based protocols to improve proprioceptive recovery after ankle restabilization for CAI.
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Affiliation(s)
- Xiao'ao Xue
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Le Yu
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Shanshan Zheng
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Xicheng Gu
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuyan Na
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Tian Xia
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Hao Jue
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Tianwu Chen
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Hong Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Hongyun Li
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Ru Wang
- School of Exercise and Health, Shanghai University of Sport, Shanghai, China
| | - Yinghui Hua
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
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Kim HJ, Jeong S, Oh YH, Suh MJ. Association of Balance Impairment with Risk of Incident Dementia among Older Adults. J Prev Alzheimers Dis 2024; 11:130-137. [PMID: 38230725 DOI: 10.14283/jpad.2023.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND A growing body of data suggests that balance impairment may be linked to the onset of dementia. OBJECTIVES However, a large-scale epidemiologic investigation is needed to clarify its association in older adults. DESIGN A retrospective-prospective hybrid database. SETTING Cox proportional hazards regression model was used to assess the relationship between balance impairment and the risk of incident dementia, and the results were provided as adjusted hazard ratios (aHR) with 95% confidence intervals (CI). All participants were tracked until the date of incident dementia, death, or 31 December 2019 whichever came first. PARTICIPANTS We analyzed 143,788 older adults who had at least one health screening between 2009 and 2019 from the Korea National Health Insurance Service-Senior Cohort. MEASUREMENTS A total of 3,774 cases of dementia were discovered throughout 850,425 person-years of follow-up investigation. Balance impairment was associated with a risk of dementia compared to those without balance impairment (adjusted hazard ratio [aHR] 1.83; 95% CI, 1.69-2.00; P value <0.001). RESULTS Risks of the Alzheimer's disease (aHR, 1.80; 95% CI, 1.65-1.96; P for trend <0.001) and the vascular dementia (aHR, 2.94; 95% CI, 1.89-4.58; P for trend <0.001) showed comparable trends and findings. CONCLUSIONS Balance impairment was found to be independently associated with an increased risk of dementia in older adults.
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Affiliation(s)
- H J Kim
- Yun Hwan Oh, MD, Msc, Department of Family Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, South Korea. . Tel.: +82-10-7202-1342. Fax.: +82-2-2610-9220; Michelle J. Suh, MD, PhD, Department of Otorhinolaryngology, Jeju National University College of Medicine, Aran 13 gil 15, Jeju, 63241, South Korea. . Tel.: +82-10-5143-5872. Fax.: +82-50-4295-5872
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23
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Serra ACS, Orlando JB, Scheicher ME. Influence of the pilates method on postural balance parameters in older women: An exploratory single-arm trial. J Bodyw Mov Ther 2024; 37:11-17. [PMID: 38432791 DOI: 10.1016/j.jbmt.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/03/2023] [Accepted: 09/04/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND Human aging is a natural, biological, progressive, dynamic and complex process that involves morphological, physiological and social changes. Alterations such as decreased postural balance increase the risk of falls and exercise has shown benefits. One of the possible exercise modalities for this population is Pilates. OBJECTIVES To investigate the effects of Pilates on parameters of static and dynamic postural balance in older women. METHODS Women aged 60 years or over were evaluated at three time points (pre-training, mid-training, and post-training). Postural balance was assessed using the Short Physical Performance Battery (SPPB), the Timed Up and Go test (TUG), and a force platform. The Pilates exercise protocol consisted of 16 sessions, twice a week, lasting 50 min each. Normality of the data was determined by the Shapiro-Wilk test. Repeated measures ANOVA followed by the Bonferroni post hoc test was used for comparison between assessments. Statistical significance was set at p ≤ 0.05. RESULTS Fourteen older women were included. Assessment on the force platform revealed no significant differences for most of the variables evaluated. There was a significant difference in SPPB scores and TUG times pre- and post-treatment (p < 0.001). CONCLUSION Pilates training significantly improved dynamic postural balance evaluated by the TUG and SPPB but did not significantly improve static balance evaluated by the force platform, although the values have decreased in most assessments.
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Affiliation(s)
- Anna Cláudia Sabino Serra
- Pos-Graduate Program in Human Development and Technologies, 1515 24A Avenue, Zip Code 13.506-900, Rio Claro, São Paulo, Brazil.
| | - Juliana Botinhon Orlando
- Pos-Graduate Program in Human Development and Technologies, 1515 24A Avenue, Zip Code 13.506-900, Rio Claro, São Paulo, Brazil.
| | - Marcos Eduardo Scheicher
- Pos-Graduate Program in Human Development and Technologies, 1515 24A Avenue, Zip Code 13.506-900, Rio Claro, São Paulo, Brazil; Department of Physical Therapy and Occupational Therapy, São Paulo State University, 737 Hygino Muzzi Filho Avenue, Zip Code 17.525-900, Marília, São Paulo, Brazil.
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Gylfadottir S, Arnadottir SA, Reynisdottir SM, Helgadottir B, Sigurgeirsson AT, Gudjonsdottir M. Evaluating the reliability and validity of the Icelandic translation of the Mini-BESTest in rehabilitation patients: an international implication for balance assessment. Physiother Theory Pract 2023:1-10. [PMID: 38044618 DOI: 10.1080/09593985.2023.2286635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/14/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND The Mini-BESTest (Balance Evaluation Systems Test) is a standardized balance evaluation tool. The psychometric properties of the Mini-BESTest are being established around the world. PURPOSE This study aimed to evaluate the reliability and validity of the Icelandic translation of the Mini-BESTest. METHODS Thirty rehabilitation inpatients (16/14 women/men), with mixed diagnoses and a range of self-assessed balance, were assessed with the: Mini-BESTest on two occasions; Activities-specific Balance Confidence Scale; Berg Balance Scale; Timed Up and Go test; and 10 Meter Walk Test. Statistical analyses included the Intraclass Correlation Coefficient (ICC), standard error of measurement (SEM), Cronbach's alpha (α), Pearson's r, and the independent t-test. RESULTS Relative reliability demonstrated good test-retest (ICC3.1 = 0.84), intra-rater reliability (ICC3.1 = 0.86), and excellent inter-rater reliability (ICC2.1 = 0.96). Absolute reliability (SEM) was 1.607, and internal consistency (α) was 0.80. Construct validity was supported by a high correlation between the Mini-BESTest and other standardized measures (r = ±0.6-0.73). The Mini-BESTest discriminated between patients with poor versus good self-rated balance (p ˂ 0.001), with no floor or ceiling effects. CONCLUSION The psychometric properties of the Icelandic translation of the Mini-BESTest are comparable with the original version and other translations. These results for this mixed patient group should be relevant to clinicians and researchers internationally.
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Affiliation(s)
- Sif Gylfadottir
- Department of Physical Therapy, Reykjalundur Rehabilitation Center, Mosfellsbaer, Iceland
| | - Solveig A Arnadottir
- Department of Physical Therapy, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | - Bjartey Helgadottir
- Department of Physical Therapy, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | - Marta Gudjonsdottir
- Department of Physical Therapy, Reykjalundur Rehabilitation Center, Mosfellsbaer, Iceland
- Department of Physiology, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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Kabul EG, Yenil S, Ulutas F, Bali M, Calik BB, Cobankara V. Evaluation of balance in patients with systemic sclerosis. Clin Biomech (Bristol, Avon) 2023; 110:106122. [PMID: 37844542 DOI: 10.1016/j.clinbiomech.2023.106122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/03/2023] [Accepted: 10/09/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND The aim was to examine static/dynamic balance and proprioception of Systemic Sclerosis by comparing healthy and relationship with demographic and disease-related data. METHODS 21 Systemic Sclerosis and 19 healthy were included.Berg Balance Scale (functional balance), Sensamove Sensbalance Maxiboard Software (static, dynamic balance:reaction time and travel time and proprioception), Scleroderma Health Assessment Questionnaire/Health Assessment Questionnaire (health status), Medsger's Disease Severity Scale, Modified Rodnan Skin Score were used in evaluation. FINDINGS Comparing the groups, there was significant difference in Berg Balance Scale (p:0.036); Health Assessment Questionnaire/Scleroderma Health Assessment Questionnaire (p:0.001); Static balance-center (p:0.001), front (p:0.001), back (p:0.001), left (p:0.001), right (p:0.021); proprioception-front (p:0.025);Reaction Time-front (p:0.031) and left (p:0.010);Travel Time-front (p:0.041) and left (p:0.014) in favor of healthy group.In Systemic Sclerosis, disease severity had moderate correlation with static balance-back (r:-0.504,p:0.020).Skin thickness had low correlation with Reaction Time-front (r:-0.449,p:0.041).Age had low correlation with Travel time-front (r:0.458,p:0.037) and proprioception-left (r:0.450,p:0.041); moderate with Travel time-back (r:0.515;p:0.017) and proprioception-front (r:0.539,p:0.012). INTERPRETATION Compared to healthy, Systemic Sclerosis had worse health status, functional balance, static/dynamic balance and proprioception.This situation is related to disease severity, skin thickness and age. Evaluations made with objective methods may have the potential to determine the extent of the problem.Clinicians can guide the treatment of patients with SSc by evaluating their static/dynamic balance and proprioception.With early treatment, additional problems that may occur due to worsening of balance and proprioception can be prevented.Proprioception and dynamic balance evaluation can be performed for older patients, static balance when disease activity is high, and dynamic balance when skin thickness score is high.
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Affiliation(s)
- Elif Gur Kabul
- Faculty of Health Sciences, Physiotherapy and Rehabilitation, Usak University, Usak, Turkey.
| | - Sinem Yenil
- Faculty of Physiotherapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Firdevs Ulutas
- Department of Rheumatology, Medical Faculty, Pamukkale University, Denizli, Turkey
| | - Merve Bali
- Faculty of Physiotherapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Bilge Basakci Calik
- Faculty of Physiotherapy and Rehabilitation, Pamukkale University, Denizli, Turkey
| | - Veli Cobankara
- Department of Rheumatology, Medical Faculty, Pamukkale University, Denizli, Turkey.
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Seth M, Horne JR, Pohlig RT, Sions JM. Pain, Balance-Confidence, Functional Mobility, and Reach Are Associated With Risk of Recurrent Falls Among Adults With Lower-Limb Amputation. Arch Rehabil Res Clin Transl 2023; 5:100309. [PMID: 38163037 PMCID: PMC10757173 DOI: 10.1016/j.arrct.2023.100309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Objective The study evaluated whether pain intensity and extent, balance-confidence, functional mobility, and balance (eg, functional reach) are potential risk factors for recurrent falls among adults with a lower-limb amputation. Design Cross-sectional study. Setting Research laboratory. Participants Eighty-three adults with unilateral lower-limb amputation that occurred >1 year prior (26 transfemoral- and 57 transtibial-level amputation; 44.6% women; 51.8% traumatic cause of amputation; N=83). Intervention Not applicable. Main Outcome Measures Participants reported on the number of falls in the past year, as well as pain intensity in the low back, residual, and sound limbs. Balance-confidence (per the Activities-Specific Balance-Confidence Scale [ABC]), functional mobility (per the Prosthetic Limb Users Survey of Mobility ([PLUS-M]), and balance (per the Functional Reach and modified Four Square Step Tests) were obtained. Results After considering non-modifiable covariates, greater extent of pain, less balance-confidence, worse self-reported mobility, and reduced prosthetic-side reach were factors associated with recurrent fall risk. Adults reporting pain in the low back and both lower-limbs had 6.5 times the odds of reporting recurrent falls as compared with peers without pain. A 1-point increase in ABC score or PLUS-M T score, or 1-cm increase in prosthetic-side reaching distance, was associated with a 7.3%, 9.4%, and 7.1% decrease in odds of reporting recurrent falls in the past year, respectively. Conclusions Of the 83 adults, 36% reported recurrent falls in the past year. Presence of pain in the low back and both lower-limbs, less balance-confidence, worse PLUS-M score, and less prosthetic-side reaching distance were identified as modifiable factors associated with an increased odd of recurrent falls.
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Affiliation(s)
- Mayank Seth
- Department of Physical Therapy, Delaware Limb Loss Studies, University of Delaware, Newark, DE
- Children's Specialized Hospital, Research Department, Union, NJ
| | | | - Ryan Todd Pohlig
- Biostatistics Core, University of Delaware, Newark, DE
- Epidemiology Program, University of Delaware, Newark, DE
| | - Jaclyn Megan Sions
- Department of Physical Therapy, Delaware Limb Loss Studies, University of Delaware, Newark, DE
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Dalvand H, Chamani N, Rahsepar-Fard K, Khorrami-Nejad M, Dadgar H. The effect of online visual games on visual perception, oculomotor, and balance skills of children with developmental dyslexia during the COVID-19 pandemic. Int Ophthalmol 2023; 43:5011-5024. [PMID: 37845578 DOI: 10.1007/s10792-023-02904-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 09/27/2023] [Indexed: 10/18/2023]
Abstract
PURPOSE To evaluate the effect of online visual games on the balance, visual perception, and oculomotor skills of children with developmental dyslexia during the COVID-19 pandemic. METHODS In this single-blind randomized clinical trial, 50 children with developmental dyslexia, aged 7 to 11 years, were recruited from rehabilitation centers in Tehran, Iran, using a convenience sampling strategy. Participants were randomly divided into two groups: intervention (25) and control (25), with close matching based on sex, age, IQ, and type of disease. The interventions consisted of web-based online computer games focusing on visual perception and oculomotor skills. Outcome measures included the Test of Visual Perception Skills-Revised, the Pediatric Balance Scale, and videonystagmography. The Wechsler Intelligence Scale for Children-IV and the Reading and Dyslexia Test were used to evaluate IQ and reading skills, respectively. RESULTS The intervention group exhibited significant post-intervention improvements in the Test of Visual Perception Skills-Revised, tracking gain, saccade latency, and saccade velocity scores (all P < 0.001). In contrast, the control group showed no significant differences in these tests in pre- and post-intervention (all P > 0.05). Notably, post-intervention comparisons between the groups revealed significant differences in smooth pursuit eye movements (P < 0.001), saccade latency (P = 0.027), and saccade velocity (P < 0.001). The Pediatric Balance Scale scores remained unchanged in both groups post-intervention (intervention: P = 0.317; control: P = 0.999). Game face validity was affirmed with impact scores above 1.5 for all items, suggesting that the games were straightforward, clear, and relevant. CONCLUSION Online visual games enhanced oculomotor and visual perception skills in children with dyslexia but did not influence balance skills.
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Affiliation(s)
- Hamid Dalvand
- Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloufar Chamani
- Department of Occupational Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Neurosciences and Movement Sciences, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland.
| | | | - Masoud Khorrami-Nejad
- Optometry Department, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Hooshang Dadgar
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
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Sultan N, Khushnood K, Qureshi S, Altaf S, Khan MK, Malik AN, Mehmood R, Awan MMA. Effects of Virtual Reality Training Using Xbox Kinect on Balance, Postural Control, and Functional Independence in Subjects with Stroke. Games Health J 2023; 12:440-444. [PMID: 37327375 DOI: 10.1089/g4h.2022.0193] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023] Open
Abstract
Purpose: To determine the effects of virtual reality training using Xbox Kinect on balance, postural control, and functional independence in subjects with stroke. Methods: The parallel double-blind randomized control trial was conducted on 41 individuals based on selection criteria. Participants were divided into two groups by concealed envelope method. Intervention group received exergaming by Xbox Kinect, and control group was given exercises comprising balance training, upper limb strengthening, and core strengthening. Berg balance scale (BBS), functional independence measure (FIM), trunk impairment scale (TIS), and timed up and go (TUG) were the outcome measures. Data were analyzed using SPSS v21. Results: Mean age of the participants of Xbox and exercise group were 58.6 ± 3.3 and 58.1 ± 4.3 years, respectively. Within group improvement was observed in both groups from baseline to 8 weeks postintervention; BBS: 34 ± 4.7 to 40.9 ± 4.9 in intervention group and 34.1 ± 4.4 to 38.1 ± 7.6 in control group, TUG: 25.6 ± 3.9 to 21.4 ± 3.8 and 28.6 ± 5.0 to 25.9 ± 4.7, TIS: 15.2 ± 1.8 to 19.2 ± 1.3 and 13.2 ± 1.7 to 15.3 ± 1.6 and FIM: 58.7 ± 7.7 to 52.5 ± 7.8 and 66.2 ± 7.6 to 62.6 ± 7.2 in intervention and control group, respectively. Between group improvement was observed in TUG, TIS, and FIM in experimental group with P-values 0.003, <0.001, and <0.001, respectively. Conclusions: Wii Fit improved functional mobility, independence, and trunk coordination extension in the stroke patients, whereas balance could be equally improved from Wii Fit and exercises. Trial Registration Number: ACTRN12619001688178.
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Affiliation(s)
- Nasir Sultan
- Department of Physical Therapy, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Kiran Khushnood
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan
| | - Sidra Qureshi
- Foundation University College of Physical Therapy, Foundation University Islamabad, Pakistan
| | - Shafaq Altaf
- Department of Physical Therapy, Shifa Tameer-e-Millat University, Islamabad, Pakistan. School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Muhammad Kashif Khan
- Shifa Department of Rehabilitation, Shifa International Hospital, Islamabad, Pakistan
| | - Arshad Nawaz Malik
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan
| | - Riafat Mehmood
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan
| | - Malik Muhammad Ali Awan
- Faculty of Rehabilitation and Allied Health Sciences, Riphah International University, Islamabad, Pakistan
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Cash JJ, Velozo CA, Bowden MG, Seamon BA. The Functional Balance Ability Measure: A Measure of Balance Across the Spectrum of Functional Mobility in Persons Post-Stroke. Arch Rehabil Res Clin Transl 2023; 5:100296. [PMID: 38163035 PMCID: PMC10757190 DOI: 10.1016/j.arrct.2023.100296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Objective To determine whether the measurement properties of an instrument that combines items from the Berg Balance Scale (BBS) and the Functional Gait Assessment (FGA) called the Functional Balance Ability Measure (FBAM) supports measuring balance across the functional mobility spectrum. Design Retrospective cohort. Setting Item-level data were from an archival research database. Participants Ambulatory individuals (N=93, BBS=50 [29-56], FGA=16 [0-30], Fugl-Meyer Assessment of Lower Extremities=27 [14-34], self-selected walking speed=0.4±0.2 m/s, mean age ± SD, 61.7±11.3y; 30.1% female) with chronic stroke (≥6 months). Interventions Not applicable. Main Outcome Measures Unidimensionality was evaluated with a principal components analysis (PCA) of residuals. FBAM rating-scale characteristics, item hierarchy, item and person fit, and person separation were investigated using the Andrich Rating Scale Model. Results PCA findings indicate the FBAM is sufficiently unidimensional. Rating scale structure was appropriate without modifying the original BBS and FGA scoring systems. Item hierarchy aligned with clinical and theoretical predictions (hardest item: FGA-gait with narrow base of support, easiest item: BBS-sitting unsupported). One item (BBS-standing on 1 foot) misfit, however, removal marginally affected person measures and model statistics. The FBAM demonstrated high person reliability (0.9) and 6 people (∼6%) misfit the expected response pattern. The FBAM separated participants into 4 statistically distinct strata, without a floor or ceiling effect. Conclusions The FBAM is a unidimensional measure for balance ability across a continuum of functional tasks. Rating-scale characteristics, item hierarchy, item and person fit, and person separation support the FBAM's measurement properties in persons with chronic stroke. Future work should investigate measurement with fewer items and whether the FBAM addresses barriers to adoption of standardized balance measures in clinical practice.
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Affiliation(s)
- Jasmine J. Cash
- Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC
- Ralph H Johnson VA Health Care System, Charleston, SC
| | - Craig A. Velozo
- Ralph H Johnson VA Health Care System, Charleston, SC
- Division of Occupational Therapy, Department of Rehabilitation Sciences, College of Health Professions, Medical University of South Carolina, Charleston, SC
| | - Mark G. Bowden
- Department of Clinical Integration and Research, Brooks Rehabilitation, Jacksonville, Florida
| | - Bryant A. Seamon
- Ralph H Johnson VA Health Care System, Charleston, SC
- Division of Physical Therapy, Department of Rehabilitation Sciences, College of Health Professions, Medical University of South Carolina, Charleston, SC
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Naz I, Turgut B, Gunay Ucurum S, Komurcuoglu B, Ozer Kaya D. Investigation of factors associated with static and dynamic balance in early-stage lung cancer survivors. J Cancer Surviv 2023:10.1007/s11764-023-01492-0. [PMID: 37964048 DOI: 10.1007/s11764-023-01492-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/25/2023] [Indexed: 11/16/2023]
Abstract
PURPOSE Balance impairment and falls are common among patients after cancer treatment. This study aimed to compare static and dynamic balance functions in lung cancer survivors (LCS) and healthy controls and to investigate the factors related to balance in LCS. METHODS Cross-sectional data were collected from lung cancer patients whose treatment had been completed within the previous 3 months (n = 60) and age and gender-matched healthy controls (n = 60). Clinical characteristics and history of falls were recorded. Pulmonary function tests and measurements of respiratory muscle strength were performed. Dynamic and static balance, fear of falling, knee-extension strength, physical activity level, dyspnea, comorbidity, and quality of life (QoL) were assessed using the Time Up and Go Test, Single Leg Standing Test, the Fall Efficacy Scale-International, hand-held dynamometer, the International Physical Activity Questionnaire, the Modified Medical Research Dyspnea Scale, the Charlson Comorbidity Index, and the European Organization for Research and Treatment of Cancer QoL Scale. RESULTS LCS reported a higher fall rate and exhibited lower dynamic balance compared to controls (p < 0.05). The number of chemotherapy cycles, number of falls in the past year, fear of falling, perceived dyspnea, forced expiratory volume in 1 s (%), maximal inspiratory pressure (%), knee-extension strength, physical activity score, and QoL score related to physical function were correlated with balance function in LCS (p < 0.05). CONCLUSION LCS had a higher risk of falls and lower dynamic balance function which might be related to various clinical and physical parameters. IMPLICATIONS FOR CANCER SURVIVORS Identifying factors related to balance should be considered within the scope of fall prevention approaches for these patients.
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Affiliation(s)
- Ilknur Naz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Balatçık Mahallesi Havaalanı Şosesi No:33/2 Balatçık, 35620, İzmir, Turkey.
| | - Büsra Turgut
- Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Izmir Katip Celebi University, Balatçık Mahallesi Havaalanı Şosesi No:33/2 Balatçık, 35620, İzmir, Turkey
| | - Sevtap Gunay Ucurum
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Balatçık Mahallesi Havaalanı Şosesi No:33/2 Balatçık, 35620, İzmir, Turkey
| | - Berna Komurcuoglu
- Dr. Suat Seren Chest Disease and Surgery Training and Research Hospital, University of Health Sciences, Yenisehir Mah. Gaziler Cad. No:331 Konak, 35170, Izmir, Turkey
| | - Derya Ozer Kaya
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Balatçık Mahallesi Havaalanı Şosesi No:33/2 Balatçık, 35620, İzmir, Turkey
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Amerian Z, ShahAli S, Rezaeian ZS, Shanbehzadeh S. Dynamic postural control in women athletes with and without nonspecific low back pain with high and low pain-related anxiety- A case-control study. BMC Sports Sci Med Rehabil 2023; 15:149. [PMID: 37936206 PMCID: PMC10631043 DOI: 10.1186/s13102-023-00764-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/02/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Low back pain is common among athletes and it has been shown that postural control is altered in the general population with nonspecific low back pain (NSLBP). Psychological factors may also predispose individuals to risk of altered postural control. Dynamic postural control is essential to the performance of athletes. This study aimed to compare the dynamic postural control between women athletes with and without NSLBP with high and low pain-related anxiety. METHODS Forty-five female athletes (15 NSLBP with high pain-related anxiety, 15 NSLBP with low pain-related anxiety, and 15 healthy (control)) were included. Pain-related anxiety was assessed using the Pain Anxiety Symptom Scale-20 (PASS-20). Based on the cut-off score of 30 for the total score of PASS-20, NSLBP patients were classified into two groups of low and high pain-related anxiety. Participants performed double-leg vertical drop jump (DVJ) and single-leg vertical jump (SVJ) tests on a Kistler force plate (type 9260AA6, Kistler Instruments Inc, Switzerland). The total root mean square (RMS) of the center of pressure (COP), COP displacement in the anteroposterior (AP), and mediolateral (ML) directions, COP mean velocity, and time to stabilization (TTS) in vertical, AP, and total directions were extracted from COP and ground reaction force data using MATLAB software. One-way Analysis of variance (ANOVA) and Welch's ANOVA were employed to compare the groups. In case of significant findings, post hoc tests were performed. RESULTS The results showed that during DJV, athletes with high pain-related anxiety had significantly greater TTS in all total, AP, and ML directions than other groups (P < 0.05). Also, the control group showed greater total RMS distance during DJV than either NSLBP group. However, no significant differences in TTS and COP parameters were found between the groups during SVJ (P > 0.05). CONCLUSIONS The findings suggest that pain-related anxiety may contribute to athletes' postural control strategies. Therefore, it is important to consider the level of pain-related anxiety during planning postural control exercises for women athletes with NSLBP.
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Affiliation(s)
- Zahra Amerian
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shabnam ShahAli
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Zahra Sadat Rezaeian
- Musculoskeletal Research Center, Rehabilitation Research Institute and Department of Physical Therapy, Faculty of Rehabilitation Sciences,, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sanaz Shanbehzadeh
- Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Park TS, Shin MJ, Shin YB, Kim SH. A new balance assessment tool for quantifying balance impairment in patients with motor incomplete spinal cord injury: Pilot study. J Spinal Cord Med 2023; 46:941-949. [PMID: 34723782 PMCID: PMC10653740 DOI: 10.1080/10790268.2021.1992592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE This study aimed to quantitatively and objectively evaluate the balance impairment in patients with motor incomplete spinal cord injury (SCI) using a new evaluation tool for balance and to assess its role in comprehensive balance assessment. DESIGN Retrospective pilot study. SETTING Rehabilitation hospital. PARTICIPANTS 14 patients with motor incomplete spinal cord injury. INTERVENTIONS None. OUTCOME MEASURES We retrospectively compared and analyzed the results of 14 patients with motor incomplete SCI who underwent various balance assessments, including the FRA510S test, using correlation. RESULTS The agreement between the FRA510S and existing balance assessment was confirmed through Bland-Altman plots; moreover, high degree of agreement was observed in Berg Balance Scale in the eye closed state and in Five Times Sit-to-Stand Test in the eye open state. CONCLUSIONS It was confirmed that the FRA510S equipment provides quantitative values for balance function. Balance assessment using the FRA510S, along with neurological, electrophysiological, and clinical tests, may provide comprehensive additional information related to falls and gait rehabilitation in patients with SCI.
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Affiliation(s)
- Tae Sung Park
- Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Myung-Jun Shin
- Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Pusan National University School of Medicine, Busan, Republic of Korea
| | - Yong Beom Shin
- Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Pusan National University School of Medicine, Busan, Republic of Korea
| | - Sang Hun Kim
- Department of Rehabilitation Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
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Kim HJ, Jeong S, Suh MJ, Oh YH. Association of balance impairment with risk of incident cardiovascular diseases among older adults. Eur J Med Res 2023; 28:455. [PMID: 37875935 PMCID: PMC10594686 DOI: 10.1186/s40001-023-01426-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 10/03/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Rapid decline in balance is a hallmark of aging, elevating the risk of falls and other age-related geriatric illnesses among older adults. OBJECTIVE Our aim was to assess whether impairment in balance function is associated with the risk of incident CVD in older adults. DESIGN Retrospective cohort analysis. PARTICIPANTS A total of 129,024 participants who had undergone health screening between 2002 and 2009 were derived from the National Health Insurance Service-Senior cohort. MAIN MEASURES Balance impairment was evaluated using the open-eyes one-leg standing (OLS) test. The association between balance impairment and incident CVD was analyzed using the Cox proportional hazards regression model. All participants were followed up with until either the date of the first incident of CVD, death, or 31 December 2019. KEY RESULTS Those with abnormal balance function (< 10 s in OLS test) had a higher risk of CVD (adjusted hazard ratio [aHR] 1.23, CI 1.16-1.31). The association was significant in both the obese and the non-obese, but it seemed to be more pronounced in the latter. Results were supported by sensitivity analyses that did not include cases of CVD development in the first 1, 2, or 3 years and that used a different criterion to define balance dysfunction (< 9 s in OLS test). CONCLUSIONS Older adults with balance impairment were found to have an increased risk of incident CVD. Patients with impaired balance function may be a high-risk population who require preventive managements against CVD.
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Affiliation(s)
- Hye Jun Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, 03082, South Korea
| | - Seogsong Jeong
- Department of Biomedical Informatics, CHA University School of Medicine, CHA University, Seongnam, 13488, South Korea
| | - Michelle J Suh
- Department of Otorhinolaryngology, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, 63241, South Korea.
| | - Yun Hwan Oh
- Department of Family Medicine, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, 14353, South Korea.
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Margalit N, Kurz I, Wacht O, Mansfield A, Melzer I. A survey of Israeli physical therapists regarding reactive balance training. BMC Geriatr 2023; 23:656. [PMID: 37833653 PMCID: PMC10571354 DOI: 10.1186/s12877-023-04356-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND 'Reactive balance training' (RBT) was developed to improve balance reactions to unexpected losses of balance. Although this training method is effective, its practical usage in the field of physical-therapy in Israel and world-wide is still unclear. AIMS This study aimed to evaluate the extent of RBT use in physical-therapy clinics in Israel, to identify the significant barriers to/facilitators for implementing RBT in clinical practice among physical therapists, and to determine which aspects of RBT most interest physical therapists in Israel. METHODS Physical therapists in Israel completed a survey using a questionnaire regarding their knowledge and use of RBT in their clinical practices. We compared the specific use of RBT among users; non-users; and open-to-use physical therapists. The odds ratios of the facilitators and barriers were calculated using univariate and multivariate logistic regression models. RESULTS Four-hundred and two physical therapists responded to a yes/no question regarding their use of RBT. Three-quarters (75.4%) of physical therapists reported using RBT in their practices. The most prevalent barrier cited was insufficient space for setting up equipment and most prevalent facilitator was having a colleague who uses RBT. Most of the respondents wanted to learn more about RBT, and most of the non-users wanted to expand their knowledge and mastery of RBT principles. CONCLUSIONS There are misconceptions and insufficient knowledge about RBT among physical therapists in Israel, indicating that they may falsely believe that RBT requires large and expensive equipment, suggesting they categorize RBT as external perturbation training only. Reliable information may help to improve general knowledge regarding RBT, and to facilitate the more widespread implementation of RBT as an effective fall-prevention intervention method.
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Affiliation(s)
- Noam Margalit
- Schwartz Movement Analysis & Rehabilitation Laboratory, Department of Physical Therapy, Faculty of Health Sciences, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, P.O.B. 653, 84105, Beer-Sheva, Israel
| | - Ilan Kurz
- Schwartz Movement Analysis & Rehabilitation Laboratory, Department of Physical Therapy, Faculty of Health Sciences, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, P.O.B. 653, 84105, Beer-Sheva, Israel
| | - Oren Wacht
- Department of Emergency Medicine, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, Ben-Gurion University, Beer-Sheva, Israel
| | - Avril Mansfield
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
- Evaluative Clinical Sciences, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Itshak Melzer
- Schwartz Movement Analysis & Rehabilitation Laboratory, Department of Physical Therapy, Faculty of Health Sciences, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, P.O.B. 653, 84105, Beer-Sheva, Israel.
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Chen Y, Du H, Song M, Liu T, Ge P, Xu Y, Pi H. Relationship between fear of falling and fall risk among older patients with stroke: a structural equation modeling. BMC Geriatr 2023; 23:647. [PMID: 37821821 PMCID: PMC10568824 DOI: 10.1186/s12877-023-04298-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 09/08/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND With reduced balance and mobility, older patients with stroke are more susceptible to fear of falling (FOF). A maladaptive form of FOF can cause excessive activity restriction, poor balance, and recurrent falls, forming a self-reinforcing vicious cycle. This study applied and adapted the FOF model to investigate the interaction between FOF and fall risk in older stroke patients. METHODS A cross-sectional study was conducted among 302 older stroke patients aged 60 and over. All participants were invited to complete the FOF, fall risk, physical activity, and balance tests, which were measured by the Falls Efficacy Scale International (FES-I), Self-Rated Fall Risk Questionnaire (FRQ), the long-form International Physical Activity Questionnaire (IPAQ-LF) and the Four-Stage Balance Test (FSBT) respectively. Data were analyzed using structural equation modeling. RESULTS The mean age of the respondents was 68.62 ± 7.62 years; 8.94% reported a high level of FOF, and 18.21% reported a moderate level of FOF. The structural equation model showed that FOF was directly associated with fall risk (β=-0.38, p < 0.001), and was indirectly associated with fall risk via physical activity (β=-0.075, p < 0.05) and balance ability (β=-0.123, p < 0.05). Depression (β=-0.47, p < 0.001), fall history (β=-0.13, p < 0.05), and female sex (β=-0.16, p < 0.05) affected FOF, while anxiety was not associated with FOF. CONCLUSIONS The increased risk of falling in older stroke patients results from a maladaptive FOF affected by depression, fall history, poor balance ability, and limited physical activity. Our results suggest that greater attention should be paid to FOF during stroke recovery and fall prevention. A multifaced intervention program encompassing physiological and psychological factors should be designed to address FOF and prevent falls.
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Affiliation(s)
- Yuanyuan Chen
- Medical School of Chinese PLA, Beijing, People's Republic of China
- Department of Cardiology, Second Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Hui Du
- Department of Cardiology, Second Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Mi Song
- Medical School of Chinese PLA, Beijing, People's Republic of China
| | - Ting Liu
- Medical School of Chinese PLA, Beijing, People's Republic of China
| | - Pei Ge
- Medical School of Chinese PLA, Beijing, People's Republic of China
| | - Yue Xu
- Department of Cardiology, Second Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Hongying Pi
- Medical Service Training Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, People's Republic of China.
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Giraudeau A, Nicol C, Macchi R, Coyle T, Mesure S, Berdha K, Orthlieb JD, Barthèlemy J. Impact of occlusal proprioception on static postural balance. Heliyon 2023; 9:e20309. [PMID: 37800066 PMCID: PMC10550569 DOI: 10.1016/j.heliyon.2023.e20309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 09/10/2023] [Accepted: 09/18/2023] [Indexed: 10/07/2023] Open
Abstract
Conflicting results on the effects of occlusal proprioceptive information on standing sway have been reported in the literature, partly due to the heterogeneity of the occlusal criterion studied and the experimental protocol used. In this study, occlusal functions, different mandibular positions and visual conditions were used to investigate the involvement of occlusal proprioception information in static postural balance. Postural adjustments of 26 healthy young adults, divided into Class I malocclusion and Class I normocclusion groups, were studied in upright position, in five mandibular positions (1 free, 2 centric and 2 eccentric), with and without vision. Due to different reported test durations, postural parameters were examined for the first and last halves of the 51.2 s acquisition time. A permutation ANOVA with 4 factors was used: group, mandibular position, vision, time window. Mean length of CoP displacement was shorter with vision (ES = 0.30) and more affected by vision loss in the free than in the intercuspal mandibular position (ES = 0.76 vs. 0.39), which has more tooth contacts. The malocclusion group was more affected by vision loss (ES = 0.64). Unexpectedly, with vision, the mean length was smaller in one eccentric occlusion side compared to the other (ES = 0.51), but independent of the left or right side, and more affected by vision loss (ES = 1.04 vs. ES = 0.71). The first-time window of the acquisition time, i.e. 25.6 s, was sufficient to demonstrate the impact of dental occlusion, except for the sway area. Comparison of the two visual conditions was informative. With vision, the weight of occlusal proprioception was not strictly related to occlusal characteristics (number of teeth in contact; centered or eccentric mandibular position), and it was asymmetrical. Without vision, the lack of difference between groups and mandibular positions suggested a sensory reweighting, probably to limit postural disturbance.
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Affiliation(s)
- Anne Giraudeau
- Aix Marseille Univ, School of Dentistry, Marseille, France
- Aix Marseille Univ, CNRS, ISM, Marseille, France
| | | | - Robin Macchi
- Aix Marseille Univ, CNRS, ISM, Marseille, France
- SEP-EA 7370, INSEP, Paris, France
| | - Thelma Coyle
- Aix Marseille Univ, CNRS, ISM, Marseille, France
| | - Serge Mesure
- Aix Marseille Univ, CNRS, ISM, Marseille, France
| | - Kelly Berdha
- Aix Marseille Univ, School of Dentistry, Marseille, France
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Phan V, Paing SL, Lee H. Characterizing postural balance on 2-dimensional compliant surfaces with directional virtual time-to-contact. Hum Mov Sci 2023; 91:103134. [PMID: 37531739 PMCID: PMC10530255 DOI: 10.1016/j.humov.2023.103134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 05/19/2023] [Accepted: 07/25/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND This study aimed to (1) investigate postural balance control on 2-Dimensional (2D) compliant surfaces using directional virtual time-to-contact (d-VTC), a novel method for VTC calculation; and (2) compare d-VTC with conventional balance measures in this context. METHODS A dual-axis robotic platform was used to simulate 2D surfaces/grounds with varying compliance levels. Twenty healthy young adults stood on the platform with either open or closed eyes. Balance was evaluated using d-VTC in multiple aspects, including temporal (VTC mean), spatial (boundary contact - BC), and control aspects (switching rate - SR). Additionally, conventional balance measures, namely center-of-pressure (COP) area and COP root-mean-square (RMS), were employed for further comparisons with d-VTC measures. Normality checks were performed using Shapiro-Wilk tests. Two-way repeated measures ANOVA tests were used to examine the effects of surface compliance and vision on postural balance, followed by post-hoc pairwise comparisons across conditions with Bonferroni correction. RESULTS The results showed that increasing surface compliance and/or absence of vision caused a significant decrease in VTC mean (all p-values <0.001; all ηp2 > 0.816). Interaction effects between surface compliance and vision on 2D and ML VTC mean were also significant (all p-values <0.019; all ηp2 > 0.355). The AP and ML BC values indicated a converging trend to 50%. No vision effect was observed (p = 0.458), but both surface compliance (p = 0.001; ηp2 = 0.522) and interaction (p = 0.002; ηp2 = 0.492) effects were significant. Decreases in SR were significant due to the compliance of the standing surface (p = 0.01; ηp2 = 0.401) but not vision (p = 0.109). COP area increased due to both surface and vision conditions (all p-values <0.001; all ηp2 > 0.872). AP and ML RMS were altered by vision (all p-values <0.001; all ηp2 > 0.741), but not by surface condition (all p-values >0.06). No interaction effect was observed in the conventional measures (all p-values >0.07). CONCLUSION Balance control is compromised by 2D compliant surfaces, which is exacerbated when vision is absent. Among all balance measures, VTC mean measures demonstrated particularly high sensitivity in identifying decreased balance capabilities, while BC and SR provided new insights into fall risks and balance control mechanisms. These insights may facilitate the development of rehabilitation training or assistive devices for fall prevention.
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Affiliation(s)
- Vu Phan
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ 85287, USA.
| | - Soe Lin Paing
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ 85287, USA.
| | - Hyunglae Lee
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ 85287, USA.
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Aryan R, Inness E, Patterson KK, Mochizuki G, Mansfield A. Reliability of force plate-based measures of standing balance in the sub-acute stage of post-stroke recovery. Heliyon 2023; 9:e21046. [PMID: 37886778 PMCID: PMC10597864 DOI: 10.1016/j.heliyon.2023.e21046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023] Open
Abstract
Background Difficulty controlling balance is one of the major contributors to the increased risk of falls among individuals with stroke. It is important to use reliable and objective measures to improve examination of balance impairments post-stroke, and to in turn inform clinical decision-making. The main objective of this study was to examine the relative and absolute reliabilities of force plate-based balance measures in quiet standing, in the sub-acute stage of stroke recovery. Methods Twenty-four people with sub-acute stroke (mean age = 61 years) performed two trials of quiet standing, each 30 s long. Sixteen force plate-based balance measures in the time, frequency, or nonlinear domains were calculated. Within-session test-retest reliabilities were investigated using intraclass correlation coefficient (ICC), standard error of measurement, and minimal detectable change. Results Mean speed of displacements of the centre of pressure along the anterior-posterior axis (ICC = 0.91; CI95 % = [0.83, 0.95]), and directional weight-bearing asymmetry (ICC = 0.91; CI95 % = [0.82, 0.95]) demonstrated high relative reliabilities, followed by the speed-based symmetry index and absolute weight-bearing asymmetry (both ICCs = 0.86; CI95 % = [0.74, 0.93]). Conclusions Mean speeds of centre of pressure, directional weight-bearing asymmetry, and speed-based symmetry index are the most reliable force plate-based measures that were evaluated in our study, and can be included in the balance assessments of individuals within the sub-acute stage of post-stroke recovery. These findings can better inform clinicians about the specific balance problems experienced by people in this population.
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Affiliation(s)
- Raabeae Aryan
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Elizabeth Inness
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - Kara K. Patterson
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
| | - George Mochizuki
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada
| | - Avril Mansfield
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Evaluative Clinical Sciences, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Physical Therapy, University of Toronto, Toronto, ON, Canada
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Barbosa GM, Saccol MF, Pinheiro SM, Costa ÍDS, Camargo PR, Scattone Silva R. Stability, performance and upper and lower extremities range of motion in elite beach handball athletes: A cross sectional study. J Bodyw Mov Ther 2023; 36:178-184. [PMID: 37949557 DOI: 10.1016/j.jbmt.2023.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/31/2022] [Accepted: 04/11/2023] [Indexed: 11/12/2023]
Abstract
Although beach handball is a popular sport worldwide, information about the functional profile in elite athletes are lacking. This study generate a descriptive profile of stability, performance and upper and lower extremities ROM in elite beach handball athletes. Secondary proposals were to compare these outcome measures between sexes and sides, and to report the frequency of athletes "at risk" according to cutoff values for shoulder ROM and dynamic postural stability of the lower extremities. Twenty-eight (n = 16 males, 28.7 ± 5.3 years; n = 12 females, 27.5 ± 5.5 years) elite beach handball athletes were tested. Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), single hop test, modified Star Excursion Balance Test (mSEBT) and passive shoulder, hip and ankle dorsiflexion ROM were assessed. Male athletes presented greater reach distance in the anterior direction [P < .0001; Mean Difference (MD): 36%] and lower reach distance in the posteromedial direction (P < .0001; MD: -29.7%) than female athletes in the mSEBT. Bilateral differences were observed for male athletes during the mSEBT, with the dominant stance limb obtaining a smaller reach distance in the anterior direction (P < .01; MD: -38.3%) and greater reach distance in the posteromedial direction (P < .0001; MD: 30.8%). Male athletes had less upper and lower extremities ROM and reached a smaller normalized single hop distance than female athletes. Most athletes presented mSEBT asymmetries and shoulder ROM deficits which have been shown to increase injury risk. Dynamic postural stability adaptations are present in elite beach handball athletes of both sexes, with more pronounced upper and lower extremity flexibility deficits in male athletes.
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Affiliation(s)
- Germanna M Barbosa
- School of Health Sciences of Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil; Rehabilitation Sciences, School of Health Sciences of Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil; Sociedade Nacional de Fisioterapia Esportiva, Brazil.
| | - Michele F Saccol
- Sociedade Nacional de Fisioterapia Esportiva, Brazil; Department of Physical Therapy, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | | | - Ítalo D S Costa
- School of Health Sciences of Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil
| | - Paula R Camargo
- Laboratory of Analysis and Intervention of the Shoulder Complex, Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Rodrigo Scattone Silva
- School of Health Sciences of Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil; Rehabilitation Sciences, School of Health Sciences of Trairi, Universidade Federal do Rio Grande do Norte, Santa Cruz, RN, Brazil; Sociedade Nacional de Fisioterapia Esportiva, Brazil
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Milne SC, Roberts M, Ross HL, Robinson A, Grove K, Modderman G, Williams S, Chua J, Grootendorst AC, Massey L, Szmulewicz DJ, Delatycki MB, Corben LA. Interrater Reliability of the Scale for the Assessment and Rating of Ataxia, Berg Balance Scale, and Functional Independence Measure Motor Domain in Individuals With Hereditary Cerebellar Ataxia. Arch Phys Med Rehabil 2023; 104:1646-1651. [PMID: 37268274 DOI: 10.1016/j.apmr.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/02/2023] [Accepted: 05/06/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To determine the interrater reliability of the Scale for the Assessment and Rating of Ataxia (SARA), Berg Balance Scale (BBS), and motor domain of the FIM (m-FIM) administered by physiotherapists in individuals with a hereditary cerebellar ataxia (HCA). DESIGN Participants were assessed by 1 of 4 physiotherapists. Assessments were video-recorded and the remaining 3 physiotherapists scored the scales for each participant. Raters were blinded to each other's scores. SETTING Assessments were administered at 3 clinical locations in separate states in Australia. PARTICIPANTS Twenty-one individuals (mean age=47.63 years; SD=18.42; 13 male and 8 female) living in the community with an HCA were recruited (N=21). MAIN OUTCOME MEASURES Total and single-item scores of the SARA, BBS, and m-FIM were examined. The m-FIM was conducted by interview. RESULTS Intraclass coefficients (2,1) for the total scores of the m-FIM (0.92; 95% confidence interval [CI], 0.85-0.96), SARA (0.92; 95% CI, 0.86-0.96), and BBS (0.99; 95% CI, 0.98-0.99) indicated excellent interrater reliability. However, there was inconsistent agreement with the individual items, with SARA item 5 (right side) and item 7 (both sides) demonstrating poor interrater reliability and items 1 and 2 demonstrating excellent reliability. CONCLUSIONS The m-FIM (by interview), SARA, and BBS have excellent interrater reliability for use when assessing individuals with an HCA. Physiotherapists could be considered for administration of the SARA in clinical trials. However, further work is required to improve the agreement of the single-item scores and to examine the other psychometric properties of these scales.
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Affiliation(s)
- Sarah C Milne
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville, Australia; Physiotherapy Department, Monash Health, Cheltenham, Australia; School of Primary and Allied Health Care, Monash University, Frankston, Australia; Department of Pediatrics, The University of Melbourne, Parkville, Australia.
| | - Melissa Roberts
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville, Australia; Physiotherapy Department, Monash Health, Cheltenham, Australia
| | - Hannah L Ross
- Physiotherapy Department, Monash Health, Cheltenham, Australia
| | | | - Kristen Grove
- Physiotherapy Department, Sir Charles Gairdner Hospital, Nedlands, Australia; Physiotherapy Department, Royal Perth Hospital, Perth, Australia
| | - Gabrielle Modderman
- Rehabilitation Services, Royal Darwin and Palmerston Regional Hospital, Darwin, Australia
| | - Shannon Williams
- Physiotherapy Department, Sir Charles Gairdner Hospital, Nedlands, Australia; Physiotherapy Department, Royal Perth Hospital, Perth, Australia
| | | | | | - Libby Massey
- MJD Foundation, Darwin, Australia; College of Public Health Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - David J Szmulewicz
- Balance Disorders & Ataxia Service, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; Monash Medical Centre, Monash Health, Clayton, Australia; The Florey Institute of Neuroscience and Mental Health, Parkville, Australia
| | - Martin B Delatycki
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville, Australia; Department of Pediatrics, The University of Melbourne, Parkville, Australia; Victorian Clinical Genetics Services, Melbourne, Australia
| | - Louise A Corben
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville, Australia; Department of Pediatrics, The University of Melbourne, Parkville, Australia; Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia
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García-Liñeira J, Leirós-Rodríguez R, Romo-Pérez V, García-Soidán JL. Static and dynamic postural control assessment in schoolchildren: Reliability and reference values of the Modified Flamingo Test and Bar Test. J Bodyw Mov Ther 2023; 36:14-19. [PMID: 37949550 DOI: 10.1016/j.jbmt.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 04/17/2023] [Accepted: 05/01/2023] [Indexed: 11/12/2023]
Abstract
INTRODUCTION Single-leg stance tests have been widely used to evaluate static balance, like the Modified Flamingo Test. The evaluation of dynamic balance on small support surfaces is the objective of some tests like the Bar Test. RESEARCH QUESTION How is the performance of postural control during the performance of these tests in schoolchildren between 6 and 11 years of age in both sexes? What are the reference values of these tests in this population? METHOD A cross-sectional study in which a total of 282 children. The evaluation included both tests. RESULTS The relative reliability was excellent (Intraclass Correlation Coefficient = 0.84-0.98), and the absolute reliability ranged between 4.5% and 7.1% for coefficient variation and between 0.5 and 1.5 for the standard error of measurement. The average results were 3.8 ± 2.7 floor touches for the Modified Flamingo Test and 5 ± 3.5 m for the Bar Test. The results of both tests improve progressively with the increase of age. DISCUSSION It can be asserted that children of different ages, as well as boys and girls of the same age, perform differently in these tests. Particularly, according to the analysis based on age subgroups, there were greater improvements in the performance of both tests between 8 and 11 years of age. CONCLUSIONS The girls obtained in both tests better results, although between 6 and 7 years of age the differences between sexes are not significant.
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Affiliation(s)
- Jesús García-Liñeira
- Faculty of Education and Sport Sciences, University of Vigo, Campus a Xunqueira, s/n, 36005, Pontevedra, Spain.
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group. Faculty of Health Sciences, Nursing and Physical Therapy Department, University of León, Ave. Astorga, 15, 24401, Ponferrada, Spain.
| | - Vicente Romo-Pérez
- Faculty of Education and Sport Sciences, University of Vigo, Campus a Xunqueira, s/n, 36005, Pontevedra, Spain.
| | - Jose L García-Soidán
- Faculty of Education and Sport Sciences, University of Vigo, Campus a Xunqueira, s/n, 36005, Pontevedra, Spain.
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Sun JN, Shan YZ, Wu LX, Li N, Xu FH, Kong XR, Zhang B. Preoperative high-intensity strength training combined with balance training can improve early outcomes after total knee arthroplasty. J Orthop Surg Res 2023; 18:692. [PMID: 37715204 PMCID: PMC10504716 DOI: 10.1186/s13018-023-04197-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 09/13/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND To investigate the effect of preoperative high-intensity strength training combined with balance training on the knee function of end-stage knee osteoarthritis (KOA) patients after total knee arthroplasty (TKA). METHODS A prospective study was conducted on end-stage KOA patients awaiting TKA. The patients were divided into an experimental group and a control group according to whether they received a preoperative training intervention. The differences in knee flexor-extensor strength, knee range of motion (ROM), timed up and go (TUG) test result, stair ascend/descend test result, Knee Society score (KSS) and Berg balance scale (BBS) score were assessed in both groups at baseline (T1), before operation (T2), 3 months after operation (T3), and 1 year after operation (T4). RESULTS After high-intensity strength training and balance training, the knee flexor-extensor strength, TUG test result, stair ascend/descend test result, and KSS were all significantly improved at T2 in the experimental group over the control group. At T3, the knee ROM, knee flexor-extensor strength, TUG test result, BBS score, and KSS clinical and functional scores were all significantly superior in the experimental group. The experimental group enjoyed a superiority in KSS clinical and functional scores until T4. Group × time and between-group interactions were found in all assessment indicators in both groups (p < 0.01). CONCLUSION Preoperative high-intensity strength training combined with balance training can enhance the knee flexor-extensor strength and balance of patients with end-stage KOA in the short term and help improve early outcomes after KOA. Trial registration ChiCTR2000032857, 2020-05-13.
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Affiliation(s)
- Jian-Ning Sun
- Department of Orthopedics, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian, China
- Department of Orthopedics, Suqian hospital affiliated to Xuzhou Medical University, Suqian, China
| | - Yu-Zhou Shan
- Department of Orthopedics, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian, China
- Department of Orthopedics, Suqian hospital affiliated to Xuzhou Medical University, Suqian, China
| | - Li-Xia Wu
- Research Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ning Li
- Department of Orthopedics, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian, China
- Department of Orthopedics, Suqian hospital affiliated to Xuzhou Medical University, Suqian, China
| | - Fei-Hu Xu
- Department of Orthopedics, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian, China
- Department of Orthopedics, Suqian hospital affiliated to Xuzhou Medical University, Suqian, China
| | - Xiang-Ru Kong
- Department of Orthopedics, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian, China
- Department of Orthopedics, Suqian hospital affiliated to Xuzhou Medical University, Suqian, China
| | - Bei Zhang
- Department of Orthopedics, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian, China.
- Department of Orthopedics, Suqian hospital affiliated to Xuzhou Medical University, Suqian, China.
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Ito T, Sakai Y, Kawai K, Yamazaki K, Sugiura H, Morita Y. Proprioceptive reliance on trunk muscles for maintaining postural stability decreases in older patients with sagittal imbalance. Gait Posture 2023; 105:1-5. [PMID: 37451033 DOI: 10.1016/j.gaitpost.2023.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 04/22/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Control of postural adjustments requires tight regulation of the spinal alignments. Sagittal imbalance may cause balance impairment and proprioceptive decline in older adults. However, the evidence on the proprioceptive mechanisms is limited, although it is known that poor proprioceptive inputs may induce spinal deformities. Thus, this study aimed to measure proprioceptive control quantifiers in older adults with sagittal imbalance to clarify the characteristic postural adjustments during proprioceptive inputs. RESEARCH QUESTION What are the specific proprioceptive postural adjustments required to maintain balance in older adult patients with lumbar spondylosis? METHODS This was a cross-sectional, observational study. The participants were classified according to the sagittal vertical axis (SVA) lengths with 50 mm as the cut-off value. The pressure displacement center was determined in 36 patients without sagittal imbalance and 68 patients with sagittal imbalance during an upright stance on a balance board with eyes closed. Vibratory stimulations of 27-272 Hz were applied to the gastrocnemius (GS) and lumbar multifidus (LM) muscles to measure the relative contributions and center of pressures of different relative proprioceptive weighting ratios (RPWs) used on postural adjustments. RESULTS The RPWs of older adults with sagittal imbalance were higher than that in those without sagittal imbalance (56-100 Hz; p = 0.013). Logistic regression analysis showed that older patients with sagittal imbalance had a significant ankle proprioception control of advantage (odds ratio: 1.1, 95% confidence interval: 1.01-1.1, p = 0.012). SIGNIFICANCE In older patients with sagittal imbalance, the reliance on hip strategy during balance control (RPW 56-100 Hz) decreases. A quantitative assessment of postural stability during proprioceptive inputs is crucial to identify dependence on proprioception signals, including postural strategy, in older patients with sagittal imbalance. Interventions to improve proprioception can improve the postural stability and strategy of older patients with sagittal imbalance.
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Affiliation(s)
- Tadashi Ito
- Three-Dimensional Motion Analysis Laboratory, Aichi Prefectural Mikawa Aoitori Medical and Rehabilitation Center for Developmental Disabilities, Okazaki 444-0002, Japan; Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya 461-8673, Japan.
| | - Yoshihito Sakai
- Department of Orthopedic Surgery, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Keitaro Kawai
- Department of Electrical and Mechanical Engineering, Graduate School of Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan
| | - Kazunori Yamazaki
- Institutional Research Center, Aichi Mizuho College, Nagoya City, Aichi Prefecture 467-0867, Japan
| | - Hideshi Sugiura
- Department of Integrated Health Sciences, Graduate School of Medicine, Nagoya University, Nagoya 461-8673, Japan
| | - Yoshifumi Morita
- Department of Electrical and Mechanical Engineering, Graduate School of Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan
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Daros Dos Santos T, Pasqualoto AS, Cardoso DM, Da Cruz IBM, Moresco RN, Ferreira da Silveira A, Martins de Albuquerque I. Effects of multimodal exercise program on postural balance in patients with chronic obstructive pulmonary disease: study protocol for a randomized controlled trial. Trials 2023; 24:532. [PMID: 37580800 PMCID: PMC10426202 DOI: 10.1186/s13063-023-07558-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 07/31/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Evidence has shown that patients with chronic obstructive pulmonary disease present significant deficits in the control of postural balance when compared to healthy subjects. In view of this, it is pertinent to investigate the effects of different therapeutic strategies used alone or in association with pulmonary rehabilitation with the potential to improve postural balance and other outcomes with clinical significance in patients with chronic obstructive pulmonary disease. This study will investigate the effects of an 8-week (short-term) multimodal exercise program [inspiratory muscle training (IMT) plus neuromuscular electrical stimulation (NMES)] on postural balance in patients with chronic obstructive pulmonary disease enrolled in a pulmonary rehabilitation program compared to individualized addition of IMT or NMES to pulmonary rehabilitation or standard pulmonary rehabilitation. METHODS This is a randomized, single-blind, 4-parallel-group trial. Forty patients with chronic obstructive pulmonary disease will be included prospectively to this study during a pulmonary rehabilitation program. Patients will be randomly assigned to one of four groups: multimodal exercise program (IMT + NMES + pulmonary rehabilitation group) or (IMT + pulmonary rehabilitation group) or (NMES + pulmonary rehabilitation group) or standard pulmonary rehabilitation group. Patients will receive two sessions per week for 8 weeks. The primary outcome will be static postural balance and secondary outcomes will include as follows: static and dynamic postural balance, fear of falling, muscle strength and endurance (peripheral and respiratory), functional capacity, health-related quality of life, muscle architecture (quadriceps femoris and diaphragm), and laboratory biomarkers. DISCUSSION This randomized clinical trial will investigate the effects of adding of short-term multimodal exercise program, in addition to pulmonary rehabilitation program, in postural balance in patients with chronic obstructive pulmonary disease enrolled in a pulmonary rehabilitation. Furthermore, this randomized control trial will enable important directions regarding the effectiveness of short-term intervention as part of the need to expand the focus of pulmonary rehabilitation to include balance management in chronic obstructive pulmonary disease patients which will be generated. TRIAL REGISTRATION ClinicalTrials.gov NCT04387318. Registered on May 13, 2020.
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Affiliation(s)
- Tamires Daros Dos Santos
- Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria (UFSM), Avenida Roraima, 1000, Santa Maria, 97105-900, Brazil
| | - Adriane Schmidt Pasqualoto
- Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria (UFSM), Avenida Roraima, 1000, Santa Maria, 97105-900, Brazil
| | - Dannuey Machado Cardoso
- Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, 90010-150, Brazil
- Centro de Ensino Superior Dom Alberto, Santa Cruz do Sul, Brazil
| | - Ivana Beatrice Mânica Da Cruz
- Programa de Pós-Graduação em Farmacologia e Programa de Pós-Graduação em Gerontologia, Universidade Federal de Santa Maria (UFSM), Avenida Roraima, 1000, Santa Maria, 97105-900, Brazil
| | - Rafael Noal Moresco
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal de Santa Maria (UFSM), Avenida Roraima, 1000, Santa Maria, 97105-900, Brazil
| | - Aron Ferreira da Silveira
- Programa de Pós-Graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria (UFSM), Avenida Roraima, 1000, Santa Maria, 97105-900, Brazil
| | - Isabella Martins de Albuquerque
- Programa de Pós-Graduação em Ciências do Movimento e Reabilitação, Universidade Federal de Santa Maria (UFSM), Avenida Roraima, 1000, Santa Maria, 97105-9000, Brazil.
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Pinheiro-Araujo CF, Rocha MR, Carvalho GF, Moraes R, Silva DC, Dach F, Bevilaqua-Grossi D. One-year changes in clinical and balance parameters in individuals of different subtypes of migraine. Musculoskelet Sci Pract 2023; 66:102806. [PMID: 37400347 DOI: 10.1016/j.msksp.2023.102806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Migraine has been associated with balance dysfunction, more pronounced in patients with aura and chronic migraine. Also, it has been suggested that balance deficits are progressive through the migraineurs lifetime. OBJECTIVE To analyze the one-year progression of balance parameters and clinical parameters associated with balance in female patients with and without migraine. DESIGN Prospective cohort study. METHODS The participants were distributed in four groups: control (CG; n = 27) migraine with aura (MA; n = 25), migraine without aura (MwA; n = 26), and chronic migraine (CM; n = 27). They performed the Sensory Organization Test, Motor Control Test and Adaptation Test protocols of dynamic posturography tests. Questionnaires about fear of falls, dizziness disability, and kinesiophobia were administered. These assessments were performed twice: baseline and after 1-year (follow-up). No intervention was performed for balance improvement, and the participants maintained their usual migraine treatment prescribed. RESULTS None of the groups differed in balance tests between baseline and follow-up. We observed a reduction in migraine frequency in MA (-2.2 days, p = 0.01) and CM (-10.8 days, p < 0.001) groups, and in the migraine intensity (-2.3 points, p = 0.001) in CM group. Significant decreases in the scores of fear of falling, dizziness disability, and kinesiophobia were observed in the migraine groups (p < 0.05), but the differences did not exceed the minimal detectable change of the questionaries scores. CONCLUSION Women with different migraine subtypes did not present balance changes in a one-year interval. The improvements in migraine's clinical features were not accompanied by improvements in balance parameters.
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Affiliation(s)
- Carina F Pinheiro-Araujo
- Health Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Monte Alegre, Ribeirão Preto, SP, Brazil.
| | - Michely R Rocha
- Health Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Monte Alegre, Ribeirão Preto, SP, Brazil.
| | - Gabriela F Carvalho
- Institute of Health Sciences, Academic Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L.), University of Luebeck, Ratzeburger Allee 160, 23562, Luebeck, Germany.
| | - Renato Moraes
- Biomechanics and Motor Control Lab, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Bandeirantes Avenue, 3900, Monte Alegre, Ribeirão Preto, SP, Brazil.
| | - Daiane C Silva
- Health Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Monte Alegre, Ribeirão Preto, SP, Brazil.
| | - Fabiola Dach
- Department of Neurosciences and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Monte Alegre, Ribeirão Preto, SP, Brazil.
| | - Debora Bevilaqua-Grossi
- Health Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Monte Alegre, Ribeirão Preto, SP, Brazil.
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Unuvar BS, Torlak MS, Gercek H, Tufekci O, Erdagi K, Işik B. Comparison and Relationship of Quadriceps Femoris Angle, Muscle Strength, and Balance in Athletes and Non-Athletes. Indian J Orthop 2023; 57:1243-1250. [PMID: 37525722 PMCID: PMC10387013 DOI: 10.1007/s43465-023-00927-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/05/2023] [Indexed: 08/02/2023]
Abstract
Objective Q-angle is an important parameter to assess quadriceps muscle's function and its effect on knee. The present study aims to investigate the potential relationships between Q-angle, muscle strength, and balance in both athlete and non-athlete populations. Methods Fifty-six athletes and non-athletes aged between 18 and 20 were included in this cross-sectional study. The Q-angle of each participant was measured using a universal goniometer. Muscle strength was evaluated using hand-held dynamometer, and static and dynamic balance were assessed using the one-leg stand test and Y balance test, respectively. Results Our findings revealed that athletes had a significantly smaller Q angle than non-athletes (p < 0.05). Furthermore, male participants had both higher muscle strength and better static balance with eyes closed than female participants (p < 0.05). Similarly, athletes had both higher muscle strength and better static balance than non-athletes (p < 0.05). Moreover, we found that the dominant limb had a significantly smaller Q angle than the non-dominant limb (p < 0.05). However, we did not observe a significant relationship between Q angle and dynamic balance (p > 0.05). Conclusion Our study suggests that individuals who participate in sports have lower Q angle values than those who do not participate in sports. Additionally, gender differences may exist in muscle strength and static balance. Furthermore, the Q angle was found to be lower in the non-dominant extremity compared to the dominant extremity. Finally, our study revealed a significant association between Q angle and knee muscle strength and static balance. Further research is needed to elucidate the underlying mechanisms of these relationships.
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Affiliation(s)
- Bayram Sonmez Unuvar
- Department of Audiology, School of Health Sciences, KTO Karatay University, Konya, Turkey
| | - Mustafa Savas Torlak
- Department of Therapy and Rehabilitation, Vocational School of Health Services, KTO Karatay University, Konya, Turkey
| | - Hasan Gercek
- Department of Therapy and Rehabilitation, Vocational School of Health Services, KTO Karatay University, Konya, Turkey
| | | | - Kenan Erdagi
- Physical Education and Sports Department, Faculty of Education, Necmettin Erbakan University, Konya, Turkey
| | - Bulent Işik
- Department of Physiology, Medical School, Karamanoglu Mehmetbey University, Karaman, Turkey
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Pourahmadi M, Negahban H, Koes BW, Fernández-de-Las-Peñas C, Ebrahimi Takamjani I, Bahramian M. The effect of dual-task conditions on postural control in adults with low back pain: a systematic review and meta-analysis. J Orthop Surg Res 2023; 18:555. [PMID: 37528400 PMCID: PMC10391969 DOI: 10.1186/s13018-023-04035-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 07/22/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Dual-task conditions, which involve performing two tasks simultaneously, may exacerbate pain and further impair daily functioning in individuals with low back pain (LBP). Understanding the effects of dual-task conditions on postural control in patients with LBP is crucial for the development of effective rehabilitation programs. Our objective was to investigate the impact of dual-task conditions on postural control in individuals with LBP compared to those without LBP. METHODS We conducted a comprehensive search of Medline via PubMed, Scopus, the Cochrane Central Register of Controlled Trials, Web of Science, and EMBASE databases, with no language restrictions, from inception to January 1, 2023. The primary outcome measures of the study were velocity, area, amplitude, phase plane portrait, and path/sway length of the center of pressure (CoP). Standardized mean difference (SMD) effect sizes were calculated, and the quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS). RESULTS From 196 studies, five involving 242 adults (≥ 18 years) met the inclusion criteria. Three studies were rated as high quality, while two were deemed moderate. In the included studies, 140 participants had non-specific LBP, while 102 participants did not report any symptoms, with mean ages of 36.68 (± 14.21) and 36.35 (± 15.39) years, respectively. Three studies had both genders, one exclusively included females, and one did not specify gender. Meta-analyses of primary outcomes revealed no significant differences in postural control between patients with LBP and pain-free controls during both easy and difficult postural tasks and cognitive load for velocity (easy: SMD - 0.09, 95% CI - 0.91 to 0.74; difficult: SMD 0.12, 95% CI - 0.67 to 0.91), area (easy: SMD 0.82, 95% CI - 2.99 to 4.62; difficult: SMD 0.14, 95% CI - 2.62 to 2.89), phase plane (easy: SMD - 0.59, 95% CI - 1.19 to 0.02; difficult: SMD - 0.18, 95% CI - 0.77 to 0.42), path/sway length (easy: SMD - 0.18, 95% CI - 0.77 to 0.42; difficult: SMD - 0.14, 95% CI - 0.84 to 0.55), and amplitude (easy: SMD 0.89, 95% CI - 1.62 to 3.39; difficult: SMD 1.31, 95% CI - 1.48 to 4.10). CONCLUSIONS The current evidence suggests that there are no significant differences in postural control parameters during dual-task conditions between individuals with non-specific LBP and pain-free subjects. However, due to the limited number of available studies, significant publication bias, and considerable statistical heterogeneity, definitive conclusions cannot be drawn. Therefore, further research comprising high-quality studies with larger sample sizes is necessary to obtain conclusive results. Trial registration PROSPERO CRD42022359263.
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Affiliation(s)
- Mohammadreza Pourahmadi
- Department of Physical Therapy, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
- Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Negahban
- Department of Physical Therapy, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Bart Willem Koes
- Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Research Unit of General Practice, Department of Public Health and the Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos (URJC), Alcorcón, Madrid, Spain
| | - Ismail Ebrahimi Takamjani
- Department of Physical Therapy, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehrdad Bahramian
- Department of Physical Therapy, College of Health Science & Professions, University of North Georgia, Dahlonega, USA
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Kweon M, Kim J. Comparison of immediate effects of myofascial release and fascial distortion model on the range of motion, pain pressure threshold, and balance in healthy adults. J Bodyw Mov Ther 2023; 35:33-37. [PMID: 37330789 DOI: 10.1016/j.jbmt.2023.04.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 03/15/2023] [Accepted: 04/15/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Many fascial therapies have been demonstrated to positively affect the range of motion, pain sensitivity, balance, daily functioning, and participation in social activities. Among these therapies, myofascial release has been extensively studied and widely used in clinical trials. The fascial distortion model was recently introduced, and it has received much attention due to its rapid onset of action and ease of application. OBJECTIVE This study aims to compare the effects of myofascial release and the fascial distortion model on range of motion, pain sensitivity, and balance, with the goal of helping therapists select the most appropriate treatment. METHODS Sixteen healthy adults were included in a prospective, randomized, single-blind study. The subjects were randomly assigned to either the myofascial release or fascial distortion model groups. The outcome measures were functional reach test, pain pressure threshold, straight leg-raising test angle, and finger floor distance. RESULTS The myofascial release and fascial distortion model groups showed significantly increased straight leg-raising angle and finger floor distance, but no between-group differences were observed (p > .05). The fascial distortion model group demonstrated significantly better pain control (p < .05), which was also better than in the myofascial release group (p < .05). The myofascial release group showed significantly improved balance control (p < .05); however, there was no difference between the two groups (p > .05). CONCLUSIONS Either myofascial release or fascial distortion model can be chosen to improve the range of motion. However, if pain sensitivity is the goal, it is expected that the fascial distortion model will be more effective.
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Affiliation(s)
- Migyoung Kweon
- Department of Physical Therapy, Daegu University, Republic of Korea
| | - JiYoung Kim
- Department of Physical Therapy, Masan University, Republic of Korea.
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García-Liñeira J, Leirós-Rodríguez R, Romo-Pérez V, García-Soidán JL. Accelerometric analysis of trunk acceleration during gait analysis in children between 6 and 11 years old: A cross-sectional study. Heliyon 2023; 9:e17541. [PMID: 37455952 PMCID: PMC10338309 DOI: 10.1016/j.heliyon.2023.e17541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 06/20/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
Background Gait analysis in children with accelerometers is of special interest in daily clinical practice, as it eliminates possible biases related to the assessor and is not very sensitivity of visual analysis. The sensitivity of data collection by these instruments makes it possible to evaluate the efficiency of body movements during gait and to better understand the degree of motor development in childhood, assessing progress within normal developmental parameters or detecting possible deficits. Research question What are the accelerations of the center of mass during normal gait in children aged 6-11 years? Methods Descriptive cross-sectional study conducted with a total of 283 school children (girls = 142). The analyzed variables were the mean and maximum values obtained in each of the three body axes and their root mean square during normal gait 10 m out, turn and 10 m back over firm ground in a straight line three times. Results The accelerometric data obtained showed similar values between sexes in each of the age sub-groups analyzed. Except for the medial-lateral axis in children aged 10-11 years where differences between sexes were detected (being significantly lower in girls). A reduction in medial-lateral axis average values over the years was also identified in both sexes. The regression models generated for the average accelerometric values showed significant values only in the average value of the medial-lateral axis. However, the maximum values were significant in all cases. Significance The preferred motor strategies of boys and girls during gait include developing mainly control and adjustment movements in the frontal plane (hence the high magnitudes recorded there). Flexion-extension movements are the most reduced over the six years of age analyzed, particularly in girls. Conversely, rotational movements are the most constant in speed in both sexes and all age subgroups.
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Affiliation(s)
- Jesús García-Liñeira
- Faculty of Education and Sport Sciences, University of Vigo, Campus a Xunqueira, s/n, 36005, Pontevedra, Spain
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group, Faculty of Health Sciences, Nursing and Physical Therapy Department, University of León, Ave. Astorga, 15, 24401, Ponferrada, Spain
| | - Vicente Romo-Pérez
- Faculty of Education and Sport Sciences, University of Vigo, Campus a Xunqueira, s/n, 36005, Pontevedra, Spain
| | - Jose L. García-Soidán
- Faculty of Education and Sport Sciences, University of Vigo, Campus a Xunqueira, s/n, 36005, Pontevedra, Spain
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50
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Borji R, Laatar R, Zarrouk N, Sahli S, Rebai H. Cognitive-motor interference during standing stance across different postural and cognitive tasks in individuals with Down syndrome. Res Dev Disabil 2023; 139:104562. [PMID: 37379660 DOI: 10.1016/j.ridd.2023.104562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 06/10/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Individuals with Down syndrome (DS) presented both cognitive and motor impairments that could influence each other. Therefore, exploring cognitive-motor interference during standing stance is relevant in this population. AIMS This study explored the dual task (DT) effects on postural balance during diverse cognitive tasks and sensory manipulations in individuals with DS, compared to those with typical development (TD). METHODS AND PROCEDURES Fifteen adolescents with DS (age = 14.26 ± 1.27 years; height = 1.50 ± 0.02; weight = 46.46 ± 4.03 kg; BMI =20.54 ± 1.51 kg/m2) and thirteen with TD (age = 14.07 ± 1.11 years; height = 1.50 ± 0.05; weight = 44.92 ± 4.15 kg; BMI =19.77 ± 0.94 kg/m2) participated in this study. Postural and cognitive performances for the selective span task (SST) and the verbal fluency (VF) were recorded during single task (ST) and DT conditions. Postural conditions were: firm eyes open (firm-EO), firm eyes closed (firm-EC) and foam-EO. Motor and cognitive DT costs (DTC) were calculated and analyzed across these different cognitive and postural conditions. OUTCOMES AND RESULTS In the DS group, postural performance was significantly (p < 0.001) altered during all DT conditions, compared to the ST situation. Moreover, the motor DTC was significantly (p < 0.001) higher while performing the VF task than the SST. However, in the control group, postural performance was significantly (p < 0.001) impaired only while performing the VF test in the DT-Firm EO condition. For both groups, cognitive performances were significantly (p < 0.05) altered in all DT conditions compared to the ST one. CONCLUSION Adolescents with DS are more prone to DT effects on postural balance than those with TD.
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Affiliation(s)
- Rihab Borji
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.
| | - Rabeb Laatar
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Nidhal Zarrouk
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Sonia Sahli
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Haithem Rebai
- Laboratory 'Optimisation de la Performance Sportive, Centre National de Médecine et Sciences du Sport (CNMSS)', Tunis, Tunisia
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